Anthony's Totally Secret Diary

/ 8:44 PM Fauci, Harris top 'Time' 2020 Person of the Year nominees November 27, 2020 – Global – 60, 300,000/1,400,000; USA – 12,800,000/263,000 Now concerned about the post-Thanksgiving surge Record number of hospitalizations at >80,000 November 28, 2020 – Global – 61,300,000/1,400,000; USA – 13,000,000/264,000 Reporting of cases will be inaccurate for the next couple of days due to Holiday. However, we can expect a post-Thanksgiving surge. Did filming with Janet Tobias and John Hoffmann for the NatGeo documentary. Went to the old RFK Stadium/Armory complex to view and film the 250,000 white flags put up by artist Susan in memory of those who died from COBID-19. Very reminiscent of the HIV/AIDS Quilt project. The crew filmed Chris and I walking through the acres of small white flags. Also filmed us from above with a drone. Trump bringing his argument before the Supreme Court. He has lost every court case (>30) except for one. The Supreme court issue relates to a lower court rejecting his claim that the Pennsylvania election was rigged. He and his lawyers (led by Rudy Giuliani) are an extreme embarrassment to the GOP and to the country. The rest of the world is looking at what is going on here incredulously. We look like a Banana Republic. I never would have imagined in my wildest dreams that our democracy would be so shook. It is still amazing how the ZGOP leaders do not abandon Trump. They are just afraid of him and what he can do after he leaves the Presidency to their political careers – Profiles in Cowardice. Received Deo et Patriae Award from Regis High School and President George W. Bush sent a letter of congratulations: Letter from President George W Got call from Ron Klain tonight at 5:15 PM. He wanted to fill me in on recent appointments (not announced yet) to make sure that I am OK with them: Josh Sharfstein (FDA), Vivek Murthy (Surgeon General), Rochelle Walensky (CDC), Jeff Zients (COVID-19 Czar), Gina Raimondo (Secretary of HHS). Ron said that Biden wanted to call me soon but he did not want to compromise me with the Trump people. They will clear with Meadows that the transition team can start getting in place and then Biden will call me. Got call last night from Mark Ghaly (Deputy Director for Community Health for the LA County Dept of Health Services). He has called me several times for advice. Frantic call saying that they are surging in LA County and very soon hospital beds will be overrun. He wants to do a 3 weeks shutdown of the city to “stop the surge” and wants my support since there is a large pushback to locking down. I agreed to support him. November 29, 2020 – Global – 61,900,000/1,400,000; USA – 13,100,000/266,000 Now at end of Thanksgiving weekend. Expect further surges (Birx’s daily report): Photos below of Fauci making rounds with Clinical Center inpatient and Clinic Staff – from October 2020 Fauci makeing rounds with Clinica PRESS: NBC Meet the Press with Chuck Todd; ABC This Week with Martha Raddatz November 30, 2020 – Global – 62,400,000/1,500,000; USA – 13,300,000/266,100 We will see in the next few weeks whether the travel associated with Thanksgiving leads to a surge upon a surge. 95,000 people are currently hospitalized with COVID-19 – new record for this outbreak. Biden putting together his team. Very diversified with women and people of color. Trump still flailing about challenging without any hint of evidence that various states were won by him. He still has his Greek Chorus of people backing him although little by little they are being less vocal and explicit about backing him. The GOP is in a crisis in that many have lost credibility by not explicitly condemning Trump. They are all afraid since he does have almost ½ the country with him. He will definitely run in 2024 and they are afraid that they will lose his support if they come out against him. Terrible situation for democracy. Got call from Gov. JB Pritzker (D-IL) praising me for what I have been doing and asking for my backing for him to keep stringent public health measures (short of lock down). He is getting pushback from bars and restaurants and even from hard core people who do not want to wear masks. He said that I am so credible and respected that he would like to quote what I have said as backup for himself. He liked my statement on Sunday shows of “Close the bars; open the schools”. He is very frustrated with people not wearing masks and told me he would like to just say: “Wear a fucking mask!” Sen. Rand Paul continues to act like an idiot: Rand Paul says Fauci owes parents and students an apology over pandemic measures BY DOMINICK MASTRANGELO - 11/30/20 12:01 PM EST 488 Sen. Rand Paul (R-Ky.) scolded Dr. Anthony Fauci in a tweet on Sunday, suggesting the nation's leading infectious disease expert apologize for his warnings about the danger coronavirus poses to school-aged children. "Dr. Fauci owes [Rand Paul] an apology," one of Paul's Twitter followers said. Paul responded: "No, he owes one to every single parent and school-age child in America. I told him this multiple times this summer." Fauci and Paul have clashed several times since the pandemic began, with the Kentucky Republican accusing Fauci of fear-mongering rhetoric and what he says is incorrect praise of so-called lockdown measures implemented to stem the spread of the virus. “Dr. Fauci, every day we seem to hear from you things we can’t do. But when you’re asked, ‘Can we go back to school?’ I don’t hear much certitude at all. ‘Well, maybe.’ ‘It depends.’ Guess what? It’s rare for kids to transmit this. I don’t hear that coming from you. All I hear is, ‘We can’t do this, we can’t do that, we can’t play baseball,’” Paul said while demanding schools reopen during a Senate hearing in late June. “It’s important to realize that if society meekly submits to an expert and that expert is wrong, a great deal of harm may occur when we allow one man’s policy or one group of small men and women to be foisted on an entire nation." Fauci responded to Paul at the hearing, saying he feels "very strongly we need to do whatever we can to get the children back to school." During the early days of the pandemic, Fauci and other public health officials urged local school districts to consider all factors before deciding if it was safe to have children and teachers return to classrooms. On Sunday, Fauci clarified his position on school closures amid a nationwide spike in coronavirus cases this fall. "The default position should be to try as best as possible, within reason, to keep the children in school, to get them back to school," Fauci said on ABC's "This Week." "If you look at the data, the spread among children and from children is not very big at all, not like one would have suspected. So let's try to get the kids back. But let's try to mitigate the things that maintain and push the kind of community spread we are trying to avoid. And those are the things you know well. The bars, the restaurants ... those are the things that drive the community spread. Not the schools." • Did weekly Governor’s call today led by VP Pence. • Moderna applied to FDA for an EUA for their mRNA vaccine. Their final data were very impressive. 94% efficacy and 30 severe outcomes, all in placebo, none in vaccine. Pfizer did this submission last week (Nov. 20) • Fireside chat with American Society of Hematology • Did a nice 60 minute Facebook Live with Mark Zuckerberg PRESS: WUSA TV interview (Gabe Cohen); WTOP Radio; Yahoo News and Sports; iheart Radio; Cheddar TV; WedMD Magazine interview (I will be one of their public health “heroes”; Facebook Live with Mark Zuckerberg; BBC World News Radio; December 1, 2020 – Global – 62,700,000/1,500,000; USA – 13,400,000/267,300 Many GOP (such as Roy Blount) still supporting Trump who is becoming more and more unhinged. He is losing every court case that he appeals to overthrow the vote in a number of states. He rales that it is all a stolen election and that he won by a landslide. Very embarrassing. Blount refuses to call Biden the President -Elect. Scott Atlas resigns! I imagine that is because everything that is happening now with the surges has finally proven him to be incorrect on virtually everything that he has said. The one area where he was correct was in saying that school children are not the drivers of the outbreak. However, he was dead wrong in saying that mitigation does nothing and that when states peak and come down, it is because they have reached herd immunity. Yet, now we are seeing states and cities that peaked high months ago and now are peaking even higher. So much for heard immunity. Rand Paul still coming after me saying that I should shut everything down. The press is contradicting him by showing quotes from me to the contrary. What a jerk! I am staying above the fray. Alex Azar is becoming more sycophantic towards Trump as we get to the end of the administration. See below: Azar Touts Swift Progress On COVID-19 Vaccine Development. Fox News (11/30, Nelson, 27.59M) reports that on Monday, HHS Secretary Alex Azar said progress on the COVID-19 has been unprecedented. He told Fox News, “Think about this: 10 months into this pandemic hitting our shores, thanks to what President Trump has done, we believe we’re going to have people getting vaccinated, millions of people, before Christmas this year. It’s just unheard of in the history of public health, this accomplishment.” He added that “the vaccine will be ‘shipped’ within 24 hours of FDA approval and then it would be up to ‘nursing homes, hospitals, and pharmacies to get that dispensed.’” California Governor: State At “Tipping Point” Of Pandemic. Reuters (11/30, Whitcomb, Caspani) reports California Gov. Gavin Newsom (D) “said on Monday the state was at a ‘tipping point’ in the COVID-19 pandemic that would soon overwhelm hospitals as political leaders nationwide turn to increasingly aggressive measures to hold back the latest • Had important call with Gov Cuomo who called me up. He was explaining to me why he had an independent panel look at the COVID-19 vaccines. He said that the skepticism about the FDA already existed (i.e. their doing an EUA for Hydroxychloroquine) and he was trying to ameliorate it. He also was concerned about managing expectations about how quickly the vaccines will make a big and broad difference. He and I agree that the difference will not be until mid to late summer. He told me about his conversations with Trump and how Trump wants to mend the fences with Cuomo despite the fact that he has been trashing him. He wants to change his residence back to NYC saying that it would be good for NYC. Cuomo pushed back and told him that he did not agree that it would be good for NYC. Also, Trump apologized for calling Chris Cuomo “Fredo”. Cuomo believes that Trump is a psychopath and an evil man who just wants to manipulate for his future, which he knows is bleak. Cuomo also expressed disdain for Azar saying that he is a sycophant to Trump and does not understand that black and brown people will not get fair access to vaccines with the paltry amount of money that the USG is giving to the states for the implementation of the vaccine distribution. USG gave $200 million to NY, when they really need $1 billion. Cuomo told me the best thing that could happen for my legacy would be for Trump to fire me and then have Biden re-hire me. • Had call with Rob Manfred, Commissioner of MLB – He needed advice about the timing of Spring Training (February for pitchers) vis-à-vis the roll out of vaccines and when there would be enough people vaccinated so that he can both get his players vaccinated and have a degree of herd immunity present so that he can have spectators in the stands. I told him that by April there could be massive vaccinations IF people uptake the vaccine. We could have most people vaccinated by early summer which means they can start with half full stadiums and then by the World Series they could conceivably have packed stadiums. He might delay start of Spring Training from February to March. Also, he wants to offer stadiums and parking lots for massive vaccination programs. I told him that would be a CDC/local public health department issue. • Had Miami Mayors call. – The mayor of Miami-Dade County – Daniella Levine Cava now has COVID-19. Former Mayor Jimenez has COVID-19. Still remaining issue that Governor DeSantis is blocking the mayors attempts to mitigate. For example, he will not allow closing the bars and indoor restaurants. • Had call with Gary Bettman (NHL) about the coming hockey season • Task Force call – The VP still extracts “happy talk” out of a very sober report from Birx about the surge and the fact that we are perilously close to having our health care system over-run by the surge upon the surge. He and the Greek Chorus of the TF just cannot accept that we are in serious trouble. Very frustrating Some states starting to plateau while others continue to surge. See below: Danger of hospitals being overrun and lack of adequate staffing (see graphs below): • Received Lifetime Achievement Award together with Henrietta Fore (Director of UNICEF) and David Beasley at elegant “virtual” gala. Praised by Barbara Bush in an interview and several celebrities • Heated discussion at TF meeting regarding the NIH Guidelines not being specific enough in its recommendations for mAb and CP. Typical Deb Birx wanting to push therapies more than the data justify. In the discussion, Pence was convinced by Deb and others (with no medical background) chimed in that saying “no evidence for or against the use of …….” Had long conversations with Cliff tonight and he is very reluctant to change the wording. VP was insistent that we indicate more strongly that the drugs work since Deb says that the clinicians are not using the drugs since they do not see a strong indication in the guidelines that the drugs work. Trying to work with Cliff who is adamant PRESS: Did Press Conference with Gov. Jared Polis (D-CO); WNBC NY TV; December 2, 2020 – Global – 63,400,000/1,500,000; USA – 13,600,000/270,000 Situation remains tenuous. Note from Deb Birx associated with her daily slide set: The situation we find ourselves is deteriorating beyond words. Please help me convey to senior leaders that is the worse combination of factors that we have seen since the beginning of the pandemic. Combining the Spring and Summer surge into a winter surge is what is deeply concerning. Despite my warnings there are OVP staff that undermine this message everyday and have greater access to the VP. I know its hard to see it coming, I know its hard to fathom, but it is coming even independent of the Thanksgiving potential due to the movement into populous states and nearly 50% of the country still believes this is being over blown, that it’s a hoax, that masks don’t work and I think the most damaging there is a set curve independent of mitigation – ie it doesn’t matter what you do it will look the same. Yes there is an epidemic curve to both mitigated and unmitigated surges BUT the peak is higher and the duration of the surge is 2X longer without mitigation. Yes when hospitals get overwhelmed people do take more precautions and flatten the curve but that results in nearly 2X the fatalities as a mitigated response. Inadequately mitigated is nearly 2X the area under the curve as mitigated – 2X the hospitalizations and potentially 2X the deaths. Finally unlike the spring the asymptomatic group under 35 will not mitigate in the same way and will continue to drive infections and that is why more precautions must be implemented now – both state level mitigation policies and personal mitigation efforts. Deb 2600+ Deaths today. Worse since the NYC surge in early Spring • Call from Mark Meadows saying that it was OK to do press conference with Gov. Cuomo. Also, he really wanted a reality check on the fact that the MHRA of the UK has given their equivalent of an EUA to the Pfizer vaccine. He wanted to know if our FDA was dragging their feet. I totally supported the FDA, Peter Marks, and Steve Hahn and said that the UK were “hot-dogging” it and that even the EMA were blasting the UK for hot dogging. It seemed that Mark was on the brink of firing Hahn. Hope I blocked that • Got call from Jeff Zients in preparation of my briefing the Biden “landing team” tomorrow. Jeff wanted to alert me that Biden will be calling me right after the briefing. • Received the Eleanor Roosevelt Prize for Global Human Rights Advancement from the American Bar Association Center for Human Rights • PEOPLE Magazine names me 2020 Person of the Year together with George Clooney, Selena Gomez and Regina King PRESS: CNN: Elton John honors Anthony Fauci on World AIDS Day; CNN Heroes with Anderson Cooper; KTVQ TV – Billings, MT; ABC News PRIME (Online); Fox TV News; Frank Bruni writes in the NY Times: Anthony Fauci is the steely superhero of my deep state, and he’s flanked and fortified by all the government health officials who also pushed back against the quackery of Scott Atlas, the Trump-flattering pandemic adviser who resigned on Monday December 3, 2020 - Global – 64,000,000/1,500,000; USA – 13,800,000/273,000 Records being broken: 3000 deaths yesterday; >100,000 hospitalizations; >200,000 new infections. With gauntlet of Today I met with President elect Biden’s landing team. It was a good meeting that was led by Jeff Zientz, Vivek Murthy, and included David Kessler, John Auerbach, Tom Inglesby, among others. We went on to discuss the challenges associated with the rollout of the vaccination campaign. In addition, I gave them my advice on what the most effective communication strategy would be for the upcoming administration. In addition, they wanted might take on what the challenges with be in the coming months of January, February, march, and beyond. It was an excellent conversation in which they all expressed their gratitude and respect for me for the work that I have been doing over the past several months. At exactly 3:00 PM, 1 hour as to the beginning of the meeting there was a prearranged call with President elect Joe Biden together with chief of staff Ron Klain. President-Elect Biden was very glad to chat with me and immediately stated that he wanted me to continue in my position as director, NIAID. In addition, he wanted me to be his chief medical adviser. Then, Ron and President elect Biden asked me a series of questions concerning some of the decisions that they would likely have to make in the coming months. Mayor Bill De Blasio called me up asking for advice about the surges that are occurring in NYC and how much of a lock down he should implement. He wanted to keep things mostly open until after the holidays and then shut down. I told him that this was a big mistake since by that time, the damage will have been done and he will have precipitated a major surge. I urged him to close the bars and restaurants and subsidize the establishments so that they do not go under. If he does that and discourages private, large gatherings, he could get away with keeping the shopping areas open. I apologize to the UK on BBC radio for implying that their process of the approval of the vaccine was rushed and sloppy PRESS: CBS News “The Takeout” with Major Garrett; Sky News UK TV; MSNBC with Andrea Mitchell; New York Times interview with Tara Pope Parker; KQED NPR Radio, San Francisco; BBC World News; New Zealand Herald (Dick Brass) print media; Bloomberg: December 4, 2020 – Global – 64,500,000/1,500,000 USA – 14,000,000/276,000 Did photo shoot and interview with Alice Park of TIME Magazine. • I called up Rosa De Lauro to congratulate her on being chosen by Nancy Pelosi as Chair of the Appropriations Full Committee. She had tears in he eyes thanking me nd saying how excited she was that Biden has announced that I would be his Chief Medical Advisor. • Spoke with Don Fehr of the NHL Players Association about the likelihood of the NFL having a season and what my projection for 2021 was. More records broken – 200,000 cases; 2885 deaths; >100,000 hospitalization. Hospitals are starting to get over-run. California starting lock-downs to avoid hospital crisis (see above figure) PRESS: NBC Today Show with Savannah Guthrie; Multiple press stories about Biden speaking with me, asking me to stay on as NIAID Director and offering me the title of Chief Medical Advisor; Greta Van Susteren “Full Court Press” TV (VOA); “Today with Kaye” Baltimore Radio Show; CNN Town Hall with Anderson Cooper and Sanjay Gupta; Biden said he asked Fauci to stay on and be a chief medical adviser in his administration By Jim Acosta, Jim Sciutto and Kate Sullivan, CNN December 5, 2020 – Global – 65,000,000/1,500,000; USA – 14,300,000/278,000 Surge continues with more records broken. California locking down because they are at 15% or less of beds available and thousands of cases of coming in for hospitalizations. Trump still insisting that the election was “rigged” and that he won by a landslide. More than 30 court cases have been thrown out as frivolous. Alyssa Farah resigns. Good for her. One of the few good people in the administration. This might mean that I am not allowed out in the media any more since she has always advocated for me. December 6, 2020 (Sunday) – Global – 65,900,000/1,500,000 USA – 14,500,000/280,000 Had important Zoom call today (11:00 AM) with Jeff Zients and Jake Sullivan – Jeff and Jake are going to make some policy announcements for the Biden tam next week (Tuesday0 and they wanted to make sure that it was cleared by me. They had 3 issues: 1) the 100 days of mask wearing. I advised that they say “at least 100 days” or give some indication that it might be longer since when they get to 100 days, we may need to extend; 2) they want to say that they will distribute100milindoses of vaccine in teh1st 100 days of the Biden administration. I warned that this might actually be an underestimate. They first need to check that we will actually have a supply (check with Perna, but also make sure that we do not seem that this is undershooting. Since we are now saying that we will have 40 million doses by the end of December and even more by the end of January, then 100 million by the first 100 days of the Biden administration is far too little; 3) Schools – I suggested that they always lead with saying that the default position is to open and keep open the schools. They also want to announce on Tuesday the important role that I will have to be the Chief medical Advisor for the Administration. They will send me the wording to make sure that I am OK with it. Gov. Cuomo called me today (1:30 PM) – He wanted to touch bases with me in anticipation for the fact that I will be joining him tomorrow on a press conference for the state of MY. He wanted to brief me on what he was going to say. He and I have a growing and strong relationship. Received a call (3:00 PM) from Olivia Dalton from the Biden Transition team asking me to participate in an event (I asked to do it virtually) in Wilmington where Biden will announce his “health team” including me. We discussed my virtual remarks and other issues. Deb Birx on MTP pleading (as I have been doing) with the public to abide by public health mitigation methods. Example of state by state increases in deaths and cases: December 7, 2020 – Global – 66,400,000/1,500,000; USA – 14,600,000/281,3000 Bracing for post-Thanksgiving surge! Deb’s Daily Report: Data and reporting has stabilized and we are back on the same accelerating curve as before the delayed reporting and substantial declines in testing over the past 10 days. This week we expect to see the beginning of the post Thanksgiving surge as this would be when the silent spread starts to impact the more vulnerable Americans. We now have only 2 states (HI, VT) and DC in the green zone, 12 in the yellow and orange zone and 36 in the red zone. We are now seeing significant resurgence in all states except VT and HI and rapidly increasing cases across America that will lead to escalating hospitalizations the end of this week into next week and then fatalities. This is the worse situation we have faced and although vaccinations will help towards the end of Jan the next 7 weeks will be overwhelming if we don’t work with states to increase their mitigation and provide the highest level of Administration support to the behavioral changes needed by every American. Deb See below for dire situation in NYC and Los Angeles At Task Force meeting on prior agreement between Deb and I, Deb says that the country is in dire straits and we need to give the message from above that this is serious and we must double down on mitigating. I jump in and say that we must be out there warning the people that if they do not mitigate, the hospitals will be over-run. The elephant in the room is that the POTUS is ignoring this and the message must come from him since the people who are not paying attention and who will not wear masks or not travel or not congregate are his people. The VP after the discussion got going for the first time ever got defensive and even hurt that we (mostly Deb) were implying that the administration was not taking the pandemic seriously. The issue is that maybe we are taking it seriously, but the POTUS and his people certainly are not. That is the lesion. The POTUS is undermining everything that we are trying to do. Deep down the VP has to realize this and still he fiercely defends the POTUS. Tragic! PRESS: CNN New Day with John Berman; Press conference with Gov. Cuomo (Boradcast from Albany, NY; Fireside chat with Norah O’Donnell (CBS) at the Milken Institute Future of Health Summit; Interview with Katy Kay for the Bloomberg American Health Summit; taping for ABC Special on Vaccines December 8, 2020 - Global 66,700,000/1,500,000; USA – 14,800,000/283,000 Harvey Alter to receive Nobel Prize in Physiology or medicine to be presented to hi at NIH (Natcher) by the Swedish Ambassador to the USA. I am invited and will use this as an excuse not to attend the “Vaccine Summit” at the White House today. Trump will use it as a PR stunt to claim credit for the vaccines. Pfizer (Bourla) and Moderna (Bancel) have pulled out of attending. Biden announced his medical team today in Wilmington, DE. I was announced as his “Chief Medical Advisor”. I have made a video of my message to the group since I cannot attend (see above). • Had call with Joan Baez who wanted information about the effectiveness of masks in protecting you from acquisition of infection. Also, she is worried about her son and daughter-in-law who want to travel to South America. She wants to be able to tell them that I said that it was ill-advised. • Call with Ellen Sigal and then Larry Horowitz about FDA Commissioner. Lots of rumors and the usual anxiety about candidates. Josh Sharfstein is being considered but many people are pushing back. Kessler is being considered, but most everyone thinks that this is a bad idea. Janet Woodcock is emerging as a top choice. I like that. • Much concern that we did not contract with Pfizer for enough vaccine; we just did not accept their offer to provide more. Now it seems that this was a big mistake. Press are all over this. • Nancy Messonnier called. She is concerned that Gen. Perna is making decisions without proper knowledge and/or consultation with CDC. She has had long-standing problem with him. • Katie and Stephen Miller called me to thank me for the baby gift I sent them for daughter Mackenzie. We had a nice discussion about life after Trump. • I was awarded “Sicilian of the Year” by the Magazine I Love Sicilia PRESS: KTWV Los Angeles Radio; BBC “Hard Talk”, TV and Radio; Wall Street Journal CEO Council; December 9, 2020 – Global – 67,800,000/1,600,000; USA – 15,000,000/285,000 Deaths reached record of 3000 today! Just waiting to realize the full brunt of the Thanksgiving holiday. Trump still totally preoccupied with trying to overthrow the election. Biden carefully putting his team together PRESS: Interview with Ed Yong of The Atlantic; CNN discussion of 1918 Influenza wuth Anderson Cooper (to be shown in a week); Fireside Chat with Sanjay Gupta for the Harvard T.H. Chan School of Public Health “When Public Health Means Business” December 10, 2020 – Global -68,200,000/1,500,000; USA – 15,300,000/289,000 217,000 cases today! I zoomed with the Novovax site investigators encouraging them in their trial and stressing the importance of recruiting minorities into the trial. The FDA’s advisory committee VRBPAC meets today for Pfizer product. They recommend approving the EUA Received the Ripple of Hope Award from the RFK Foundation. Wonderful virtual ceremony with co-awardees: Colin Kaepernick, Dolores Huerta (Activist), Dan Schulman (CEO PayPal), Dan Springer(CEO, Docusign). Very warm and moving tributes. I am chosen as Time Magazine “Guardian of the Year” PRESS: CBC Canadian Radio; CNN with Chris Cuomo; December 11, 2020 Global USA Numbers continue to be stunning with >200,000 news cases each day; >3000 deaths per day; 289,000 total deaths and 15,3000,000 cases • Received a call from Ethel and Kerry Kennedy explicitly inviting up to Hyannisport for 4th of July weekend. They were so nice over the phone. They said that they loved and admired me and were so please that the Kennedy family could honor me. PRESS: NY 12 TV (NY, CT, NJ); JAMA Livestream with Howard Bauchner; MSNBC with Ari Melber; December 12, 2020 – Global – 69,500,000/1,600,000; USA – 15,700,000/295,000. FDA has approved an EUA for the Pfizer mRNA vaccine for people 16 years and older!! USG authorized an additional 100 million doses of Moderna mRNA (in addition to the original 100 million that we contracted for. Although some states that are mitigating are showing stabilization, several others are showing the impact of the Thanksgiving holiday. • Had Zoom call with Jeff Zientz and Natalie Quillian about what the Biden team should be doing as they hit the ground on January 21. I mentioned: 1) the importance of a clear and consistent message from above; 2) the importance of testing (diagnostics) for asymptomatic people for the purposes of surveillance and screening such as in schools (mentioned my conversation with Raj Shah and the Rockefeller Foundation people) about testing school teachers 2x per week and K-12 children 1x per week. Also early testing is key for early treatment; 3) Treatment – importance of early treatments with either direct anti-virals or perfect the mAb and hyper immune-Ig; 4) Make sure that vaccines are smoothly and equitably distributed. There has been much play in the media over the past few weeks about what they are calling the “Fauci effect” whereby the medical school admission have gone up about 50% over the past year due in large part to students realizing what I have been doing and able to accomplish as a physician and this is inspiring them to go to medical school. See story from NPR below: 'Fauci Effect' Drives Record Number Of Medical School Applications • Facebook • Twitter • Flipboard • Email December 7, 20207:56 AM ET JON MARCUS PRESS: TWEET FROM BIDEN - I've seen him take on HIV/AIDS, H1N1, Ebola, Zika, COVID19, and every infectious disease in between, over his nearly forty years of service to our country. Trusted. A truth teller. A patriot." — President-elect Biden on Dr. Anthony Fauci I was portrayed on Saturday Night Live by Kate McKinnon. A spoof with me and Deb Birx. They slammed Deb December 13, 2020 (Sunday)- Global – 70,200,000/1,600,000 USA – 16,000,000/298,000 Vaccine dose from Pfizer now being shipped to various locations. Cases continue to explode throughout the country. Statement from Birx below: PRESS: CNN HEROES – INTERVIEW WITH ANDERSON COOPER December 14, 2020 - Global USA - 16 Vaccine doses are being shipped as I write this. Vaccinations will start today. Discussions ongoing whether to vaccinate the White House staff. Also Jeff Zientz wants to speak with me about when the President-elect and VP-elect should be vaccinated. • Bitter-Sweet day – vaccinations start but we reach landmark of 300,000 Americans have died of COVID-19 • Call from Sen. Joe Manchin (D-WVA) asking whether I recommend that he and others get vaccinated. Also, wanted to know which was better Moderna or Pfizer. I]assured him that they were equal. • Received virtually the 2020 John Maddox Prize for Standing Up for Science from Nature magazine PRESS: BILD German Online TV interview; MSNBC with Hallie Jackson; Bloomberg Law interview with Jeanne Bauman; BBC Newsnight TV interview; December 15, 2020 - Global – 71,400,000/1,600,000; USA – 16,300,000/300,000 Brian Morgenstern is the new White House media person who seems to have taken over from Alyssa Farah. He has been OK with getting me out there, but there was a recent issue where Jon Karl (ABC) has been asking for me a lot and not getting approved. Jon is rather pissed. Jared Kushner called to congratulate and thank me for our efforts to develop safe and effective vaccines for COVID-19. PRESS: ABC - Good Morning America with George Stephanopoulos; NPR “Morning Edition” with Rachel Martin; VOX (Online TV) – “Today Explained” with Sean Rameswaram; Nature’s 10: ten people who helped shape science in 2020 Anthony Fauci: Science’s defender • A storied US doctor became his nation’s conscience on COVID-19 even as detractors threatened his life. By Heidi Ledford Credit: Al Drago/Getty In his more than 40-year career as an infectious-disease researcher, Anthony Fauci has been hailed as a hero and damned as a murderer. His most dedicated fans have created baseball cards and bobble-head dolls in his likeness, whereas others have issued death threats and harassed his children. As head of the US National Institute of Allergy and Infectious Diseases (NIAID) in Bethesda, Maryland, Fauci has guided six presidents and an anxious nation through fears of bioweapon attacks and outbreaks of HIV, Ebola and Zika. Now, his role advising the government and communicating to the public during the coronavirus pandemic has made him the nation’s doctor. He has offered guidance on the US response to the outbreak, often in conflict with the wishes of President Donald Trump, and he has made time to treat individuals with COVID-19 and HIV in the clinic. “Seeing the patient really gives you a different feel for what the disease is,” says Fauci, who works 18 hours a day, 7 days a week. The scale of the COVID-19 pandemic — and the politicization of the public-health response to it — has forced Fauci to go far beyond anything he’s done before, says epidemiologist Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota in Minneapolis. “He has been a very key part of trying to help the public understand what the science means and what we can do about it — and that includes, of course, our elected leaders,” says Osterholm. Those efforts were met with resistance, but Fauci is no stranger to friction. At the height of the AIDS epidemic, in 1988, playwright Larry Kramer called Fauci a “murderer” and an “incompetent idiot” on the cover of the San Francisco Examiner magazine. Kramer and other AIDS activists felt that the NIAID’s clinical trials for HIV drugs were moving at a glacial pace while thousands of people were dying. When a group gathered outside his office to protest, Fauci invited some in for a chat. Over time, he built a relationship with them that would lead to changes in the way people with AIDS got access to experimental drugs. It was a revolutionary approach at a time when people with a disease had little say in the science aimed at treating them. “That was a tough period,” he says. “There were many scientists who thought that I was caving in”. Warm but blunt, with a pronounced Brooklyn accent, he has often worked well with political leaders. Former US president George H. W. Bush called him a hero for his work on AIDS, and Fauci worked with his son, former president George W. Bush, to design the President’s Emergency Plan for AIDS Relief (PEPFAR), a global programme to provide treatment for people with HIV. But this year, his staid and steady advocacy for public-health measures to slow the spread of COVID-19 earned him stiff criticisms from President Donald Trump and others who were eager to play down the severity of the pandemic and get the US economy restarted. Trump has suggested that he might fire the scientist, and a stream of vitriol has poured from some of the president’s followers. Steve Bannon, a former Trump adviser, said that he would like to see Fauci’s head on a pike outside the White House. Fauci now has federal guards overseeing his security. The threats made him “more pissed off than afraid”, he says. “I’m out there trying to give a public-health message to save people’s lives.” But some researchers were also frustrated with Fauci’s public performance. He often stood next to Trump during press briefings as the president repeatedly misrepresented the severity of the pandemic. Although Fauci sometimes contradicted Trump, he did not directly confront the president. Such briefings stopped in April. Fauci has since become more outspoken, says Mark Harrington, executive director of Treatment Action Group, a New York City think tank that focuses on the treatment and prevention of AIDS, tuberculosis and hepatitis C virus. “He’s been speaking truth to power for the last few months in a way that none of the other people in the task force or federal government have been doing,” Harrington says. Fauci, who turns 80 in December, has no plans to retire soon. He has agreed to stay on at the NIAID and to serve as president-elect Joe Biden’s chief medical adviser. Osterholm says he expects Fauci to continue to have an active role in front of the cameras. But Harrington is looking forward to the day when Fauci can focus his attention again on other pressing concerns, such as HIV and hepatitis C. “He needs to be able to do his day job,” he says. “It’s a big job.” December 16, 2020 – Global – 72,000,000/1,600,000; USA – 16,500,000/303,000 Surge continue in some areas and leveling in others. On phone last night with the David Barr group. Chicago (Alison) doing better, but LA (Sharon) doing worse. Bitter sweet situation as vaccines rolling out (Moderna coming within the next couple days) while records being broken with deaths and hospitalizations: PRESS: CBS This Morning with Gayle King; Interview with Rodney Edwards of Irish Independent Sunday print paper; CNBC “Healthy Events” with Meg Tirrell December 17, 2020 – Global – 72,900,000/1,600,000; USA – 16,800,000/306,000 The surge continues. Some states improving; others getting worse (see below for CA, TX, among others) 3656 deaths yesterday – another record!! Red flag in CA, TX, PA, FL, TN as their absolute number of cases and rate of rise of cases is deeply concerning. If these populous states have the same depth and breadth of the surge experienced in the Northern Plains hospitalizations and fatalities will dramatically increase over the next 2 weeks. Deb • Had good conversation with Christopher Whitty (Chief Medical Officer of the UK) and Sir Patrick Vallance (Chief Scientific Advisor to the UK Government) regarding comparing notes between UK experience and USA experience. Of note, the UK is seeing more than just the two instances of anaphylactic reactions to the mRNA vaccine of Pfizer • VRBPAC approves the Moderna product. Waiting for FDA to officialy issue the EUA. Likely will start vaccinating with Moderna in a few days PRESS: WUSA TV with Gabe Cohen; FOX TV with Bill Hemmer; Alan Alda Fireside Online Chat – “Soldiers of Science” December 18, 2020 – Global – 73,300,000/1,700,000; USA – 17,000,000/310,000 Moderna’s mRNA vaccine gets EUA from FDA. Likely start vaccinating within a few days (likely Monday, 21 December) Just found out that NIH will finally get doses of vaccine from Moderna (see above) which means I will likely get vaccinated on Tuesday, 22 December. I am insisting that I receive vaccine ONLY if Clinical Center ICU people ALSO receive it at the same time as I do, • Cases continue to surge. Deb’s comments: Continued deterioration in CA, AZ, NV,TX, FL, PA, OH, NJ, NY and will need staffing support in most of these states except FL and TX – most concerning is CA and NV for ICUs and hospital staffing. States are now using their vents that are in their state stockpiles which is the first we have seen this occur since summer. There is significant diversity in approach to vaccination – many states approach are self defined co-morbidities which could lead to long lines if its not a combination of age plus – ie first group essential worker over 50 and general population over 65 combination of risk of exposure and risk of severe disease. Mortality from the states that have been improving is still very high daily. Deb Did ceremonial vaccination with the Pfizer Product of VP Pence, Karen Pence and Jerome Adams in EEOB-350 at 8:03 AM. I gave remarks at the ceremony talking about the challenges ahead, the bitter-sweet nature of the situation with Bitter (record number of cases) and Sweet (Vaccines here). Also light at the end of the tunnel PRESS: NBC Today with Savannah Guthrie; on CNN for live coverage of the White House vaccination of the VP; Taped CNN Sesame Street with Sanjay Gupta and Erika Hill; WCBS Radio NYC; Stanford Fireside Chat with Alan Alda; Fireside chat with Andy Slavitt; Fireside Chat with the California State University systems; CNN Town Hall (done together with Jerome Adams) with Don lemon and Sanjay Gupta December 19, 2020 – Global USA Deb’s daily comment: Coasts and Sunbelt continue to deteriorate. AZ, MS, FL, GA are not mitigating to the level of summer mitigation policies. There is deep confusion out there about vaccine volumes and clarity on the 1b and 2 categories to most efficiently vaccinate and potential to use the current supply to save lives over the next 30 days. The word is the ACIP was supplied modeling in October that showed no impact of vaccination on lives saved but it was modelled without taking into account a surge of cases and hospitalizations. IF this is true this needs to be addressed and remodeled and that new data supplied to the ACIP. Deb Another record broken: Covid-19 Live Updates: U.S. Sets Daily Record With Over 250,000 Cases December 20, 2020 – (SUNDAY) – Global – 75,100,000/1,700,000; USA – 17,600,000/315,300 See Deb’s notes below: 1. The Northern Plains, Upper Mid-West, Rocky Mountain States and Heartland continue to improve decreasing test positivity, cases, hospitalizations. Strong vigilance messaging should continue to ensure decline through the upcoming Holiday season. 2. The Coasts (80% of America's population) are now driving the increasing cases, hospitalizations and soon deaths. The rate of rise is deeply concerning as it is similar to the Northern Plain States. New strain of virus – B.1.1.1.7 arising in UK with concern that it is spreading much faster that other strains. Some EU countries are banning flights from UK. Probably an overreaction since there is no evidence that the strain is more virulent or that it escapes vaccineinduced immunity. We (VRC/NIAID) will start examining for these issues. PRESS: Despite the approval of Moderna vaccine a few days ago, I was not allowed on any Sunday TV shows. FOX and MTP wanted me. Need to emphasize the dysfunction of the White House Comms group, particularly Roma Daravi. It seems that she has a thing with me. Washington Post (Yasmeen Abutaleb et al): The inside story of how Trump’s denial, mismanagement and magical thinking led to the pandemic’s dark winter December 21, 2020 Global USA Much concern and discussion about the mutant virus (see above) that is in UK and South Africa. I will be speaking with the Biden people about this today. 1.The Northern Plains, Upper Mid-West, Rocky Mountain States and Heartland continue to improve decreasing test positivity, cases, hospitalizations. Strong vigilance messaging should continue to ensure decline through the upcoming Holiday season. 2.The Coasts (80% of the population) are now driving the increasing cases, hospitalizations and soon deaths. The rate of rise is concerning, however due to aggressive mitigation there is a more rapid stabilization of cases then we saw in the Fall with the center of the country which should lead to an earlier peak if the Holiday Season surge can be blunted. Had Zoom call with Biden. Also, present were Ron Klain, Jeff Zientz, Rochelle Walensky; Natalie Quillian; Vivek Murthy. Discussion centered around: 1) state of the outbreak (me); 2) Mutants from UK (me); 3) vaccine rollout (Vivek). I strongly recommended not banning travel from UK. Ron Klain and Biden were not so sure. Ron suggested that we might have a 10 day ban over the holidays. I pushed back and said that this would not help since the virus would come from other places. I suggested that we very explicitly state that we are watching this very carefully and are all over it. The potential effects of the mutation is : 1) increased transmissibility; 2) increased virulence; 3) evasion of protection from vaccine (and to some extent from mAb). All of these are testable. Bottom line – do not do anything precipitous, but watch it closely PRESS: BBC Interview with Jeremy Farrar to be aired on December 28, 2020;SiriusXM Sports – Mad Dog with Chris Russo; Telemundo TV with Randy Serrano; Fivethirtyeight ABC Podcast with Anna Rothschild; PBS NewsHour with Judy Woodruff; December 22, 2020 – Global -76,300,000/1,700,000; USA – 18,000,000/319,000 Hospitalization at 118,000 – record for the pandemic. East and West coasts now surging. PRESS: Good Morning America (ABC) with CeciliaVega; BBC World News TV; Briefed New York Daily News editorial board; CBC TV (Canada) News Show – “The National”; Fox News with John Roberts; Politico Instagram Live with Sarah Owermohle; CNN The Situation Room with Wolf Blitzer Slate ranked me the #1 most influential 80 year old and older person: The Most Influential 80-Plus-Year-Olds in America Here are the top 20. By Molly Olmstead December 23, 2020 – Global – 76,900,000; 1,700,000; USA – 18,200,000/321,700 Mayer Bowser of DC declared December 24, 2020 “Anthony S. Fauci, M.D. Day in Washington, DC: “Dr. Fauci has been a hero to our nation during this incredibly difficult year, working tirelessly to save lives and guide our nation’s response to and recovery from the pandemic,” said Mayor Bowser. “We are incredibly proud to count him among the many DC residents who are sacrificing so much to keep our communities healthy and safe. I issue this honor on behalf of all Washingtonians in gratitude and recognition of Dr. Fauci’s service to our nation and our city.” “Surprise” tribute to me from the 1st responders at NIH and Montgomery County: https://drive.google.com/file/d/10Vi4mozXkpCjolo9phs0XoWpwoxSJ_oj/view?usp=sharing A group of activists from “the old days” surprised me with a surprise birthday party on Zoom in my office at 4:30 PM. Organized by Peter Staley and Janet Tobias. On the Zoom were: Gregg Gonsalves, Peter Staley, David Barr, Mark Harrington, Jim Eigo, James Kellerstein, Peggy Hamburg, Judy Auerbach, Wafaa El Sadr, Matthew Rose, Moises Agosto Had Zoom call last night with Vivek Murthy, Rochelle Walensky and David Kessler. Vivek wanted to discuss in more detail what our advice would be to Biden regarding the mutant virus in the UK. We discussed options of 1) shutting down travel from UK; 2) requiring pre-boarding testing from UK flights or even all flights from EU and South Africa or even all foreign flights; 3) also discussed post-landing strategy such as giving people BINAX tests to take home and test themselves after they arrive. Seems we will recommend at least pre-boarding testing, probably from all of EU and RSA. Surge continues in some areas and decreases in others. Deb’s notes: There is a growing evidence showing aggressive public mitigation and clear messaging together does flattening the curve. When one compares TN to OH, NC, WVA, KY – surrounding states. TN fatalities/pop is 30-40% higher as states with more aggressive mitigation as it decreases the area under the curve – decreasing hospitalization and deaths per populations. When all is done excess mortality will be greater in states with less mitigation when normalized for population age and other multivariants. Deb 1.The Coasts (80% of the population) are now driving the increasing cases, hospitalizations and soon deaths. The East and West Coast, Sunbelt, IN, OH, KY, TN, WVA surging cases will drive cases and hospitalizations over the next week stressing their hospital systems and and inpatient care The Vaccine Before Christmas By Kevin A. Wilson (with apologies to Clement Clarke Moore) ‘Twas some days before Christmas—how many I’m not sure (The days ran together; everything was a blur). All the houses were locked down from COVID-19, With everyone wishing for the promised vaccine. The children were nestled and sleeping just fine. They were all tuckered out from their classes online. And mamma in her kerchief and I in my cap Had just sanitized our hands and hung up our masks. The year had been hard. We were due a vacation. But the thing wanted most? Emergency use authorization. Then out on the lawn there arose such a clatter, I assumed it was another 2020 disaster. I ran to the window and put on my mask, But what would I see? I was too scared to ask. The neighbors were quiet and socially distant, Awaiting the time they’d be COVID resistant. But despite travel bans, there then did appear A miniature sleigh and eight tiny reindeer. But this wasn’t Santa. His gut wasn’t paunchy. It was the trusted presence of Anthony Fauci. More rapid than eagles, at warp speed they came, And he whistled, and shouted, and called them by name: “Now Pfizer! Now Sanofi! Now Johnson & Johnson! “On Moderna! On BioNTech! On Adaptive and Amgen! To the top of the porch! To the top of the wall! Now vaccinate, vaccinate, vaccinate all!” As a virus expelled by a cough or a sneeze When it meets plexiglass rises up on the breeze; So up to the house-top the pharma all flew, With the sleigh full of hope, and Dr. Fauci, too. And then, in a twinkling, I heard on the roof The prancing and pawing of each little hoof. As I drew in my head, and was turning around, Down the chimney Fauci came with a bound. He was dressed in a suit, as was always his way, And his neatly cut hair was a smart silver-grey. A chart in one hand, a syringe in the other, And a medical bag—a gift from his mother. The wisdom in his eyes and the knowledge in his head Soon gave me to know I had nothing to dread. With his reassuring smile covered up with a mask, His no-nonsense style led him straight to the task. He sprung to my side as I rolled up my sleeve, And he stuck in the vaccine as quick as you please. He flew to the bedroom, gave mamma a shot, Then vaxxed both our kids without waking them up. Inoculations complete, he returned to the chimney, And gave me a pamphlet about what he put in me. NEWS CLIPPING — BLOOMBERG — CONDENSED (1 SOURCE PAGE) “Then raising his finger but not touching his nose, And giving a nod, up the chimney he rose. “C’mon, team!” he said. “We’ve a great opportunity. If we vaccinate more we can reach herd immunity!”…” Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases and head of the U.S. pandemic response, on Dec. 12. (André Chung for The Washington Post) By Joel Achenbach at 8:00 a.m. EST December 24, 2020 – Global – 77,500,000/1,700,000; USA – 18,400,000/325,000 I am 80 years old! Amazing number of Birthday wishes coming in. Truly moving…. Birthday video from the OR Nursing/DPM staff in the NIH Clinical Center: Dr. Fauci.pptx Beautiful and loving tribute to me from my children on a video: https://drive.google.com/file/d/1wgTkwmAlUhlnLKzIhWPlIR4E4WPpUMh6/view?usp=drivesdk Joan Baez texted me: “HAPPY FUCKING BIRTHDAY AND MANY MORE” Nature magazine picked me as one of Nature’s 10 – People who shaped science in 2020. Over the past 3 weeks I have been on the cover of TIME magazine X2, once as one of the 100 most influential people in the world again as the “Guardian of the Year”. Also, on the cover of People magazine By Kevin A. Wilson (with apologies to Clement Clarke Moore) ‘Twas some days before Christmas—how many I’m not sure (The days ran together; everything was a blur). All the houses were locked down from COVID-19, With everyone wishing for the promised vaccine. The children were nestled and sleeping just fine. They were all tuckered out from their classes online. And mamma in her kerchief and I in my cap Had just sanitized our hands and hung up our masks. The year had been hard. We were due a vacation. But the thing wanted most? Emergency use authorization. Then out on the lawn there arose such a clatter, I assumed it was another 2020 disaster. I ran to the window and put on my mask, But what would I see? I was too scared to ask. The neighbors were quiet and socially distant, Awaiting the time they’d be COVID resistant. But despite travel bans, there then did appear A miniature sleigh and eight tiny reindeer. But this wasn’t Santa. His gut wasn’t paunchy. It was the trusted presence of Anthony Fauci. More rapid than eagles, at warp speed they came, And he whistled, and shouted, and called them by name: “Now Pfizer! Now Sanofi! Now Johnson & Johnson! “On Moderna! On BioNTech! On Adaptive and Amgen! To the top of the porch! To the top of the wall! Now vaccinate, vaccinate, vaccinate all!” As a virus expelled by a cough or a sneeze When it meets plexiglass rises up on the breeze; So up to the house-top the pharma all flew, With the sleigh full of hope, and Dr. Fauci, too. And then, in a twinkling, I heard on the roof The prancing and pawing of each little hoof. As I drew in my head, and was turning around, Down the chimney Fauci came with a bound. He was dressed in a suit, as was always his way, And his neatly cut hair was a smart silver-grey. A chart in one hand, a syringe in the other, And a medical bag—a gift from his mother. The wisdom in his eyes and the knowledge in his head Soon gave me to know I had nothing to dread. With his reassuring smile covered up with a mask, His no-nonsense style led him straight to the task. He sprung to my side as I rolled up my sleeve, And he stuck in the vaccine as quick as you please. He flew to the bedroom, gave mamma a shot, Then vaxxed both our kids without waking them up. Inoculations complete, he returned to the chimney, And gave me a pamphlet about what he put in me. Then raising his finger but not touching his nose, And giving a nod, up the chimney he rose. NEWS CLIPPING — ABC NEWS — CONDENSED (1 SOURCE PAGE) ““C’mon, team!” he said. “We’ve a great opportunity. If we vaccinate more we can reach herd immunity!” Then he yelled back to me, as the sleigh quickly rose, "I’ll be back in a fortnight for…” By Ben Cohen at ben.cohen@wsj.com and Louise Radnofsky at louise.radnofsky@wsj.com December 25, 2020 – Global – 78,00,000/1,700,000; USA – 18,600,000/328,000 Trump at Mar-a Largo while country in crisis. Cases still surging in certain areas (see below). Relief bill in purgatory since he does not want to sign it because of disagreement about amount of relief ($600 versus $2000). Everyone had agreed to $600 even though the Dems wanted more. White House staff agreed to the bill. Sent to Trump for signature, except that now that he has finally looked at it, he wants the $2000 per person, which is what the Dems wanted to begin with, and the GOP objected to. And so now, he is bucking against his own GOP. In the meantime, people are starving without aid. Also, the USG might shut down since the Omnibus budget bill has not been signed either. Amidst all this, Trump is pardoning a large number of people (>40), almost all who were involved in the issues surrounding the probe of him and the impeachment matters. He also pardoned Gen. Flynn, Roger Stone, and Charles Kushner. Deb’s daily report: Aggressive post Holiday testing of those who gathered and rapid utilization of Mab in those at highest risk for severe outcomes will be critical over the next 2-3 weeks to blunt the impact of Holiday gatherings. Deb 1. Summarizing the current state of the pandemic : overall the USA is at a high plateau for cases and hospitalizations and due to lagging fatalities reporting in improving states we won't see the fatality plateau until the next 2 weeks 2. I summarized the top 10 states in this data summary for cases in order : CA, FL, NY, GA, PA, OH, TX, AZ, IL, IN – slides 11-20 – of these states only PA, OH, IL are improving the others are escalating or at a high plateau. 3. Data will be unstable for the next 2 weeks with both Christmas and New Years but will be tracking new admissions and rate of new admissions 4. The current pandemic state is a combination of continued improvement in the center of America and continued deterioration in CA, NV, TX, across the sunbelt and up the East Coast and including TN and WVA PRESS: Print version of Joel Achenbach’s feature on my birthday appeared in the Washington Post. December 26, 2020 – Global – 78,400,000/1,700,000; USA – 18,700,000/330,000 1. Data will be unstable for the next 2 weeks with both Christmas and New Years but will be tracking new admissions and rate of new admissions 2. 24 States did not report yesterday on critical pandemic parameters and will cause a surge in cases and fatalities due to this reporting issue in the next few days 3. Summarizing the current state of the pandemic : overall the USA is at a high plateau for cases and hospitalizations and due to lagging fatalities reporting in improving states we won't see the fatality plateau until the next 2 weeks Adrienne Arsht sent me an amazing video that she asked Robert Pullen (Kennedy Center) to put together to celebrate my 80th birthday. They gathera whole bunch of celebrities to sing to me and offer words of praise and congratulations: Orlando Bloom, Mila Kunis and Ashton Kutcher, Amy Poehler, Lily Tomlin, Sophia Bush, Matthew McConaughey, Steve Buscemi, Magic Johnson, Joan Baez, and many others. It was very moving. Situation unchanged. Still outrage that Trump is messing up the relief bill. Harmony Foundation gave me: Top US doctor among 10 to get Mother Teresa Award Mohammed Wajihuddin / TNN /

, 09:38 IST PRESS: Good historical documentation of the CDC screw-up with the COVID-19 test by David Wilman in the Washington Post - The CDC’s failed race against covid-19: A threat underestimated and a test overcomplicated The Atlanta headquarters of the Centers for Disease Control and Prevention. (Ron Harris/AP) By David Willman at 8:00 a.m. EST Add to list December 27, 2020 – Global – 79,200,000/1,800,000; USA – 18,900,000/331,000 Deb’s note for the day: Hospitalizations had stablized and specific metros were significantly declining so we will be able to see a post-Holiday surge in cases and hospitalizations and predict depth of surge impact by 10 Jan. 1. Data will be unstable for the next 2 weeks and decreases cannot be interpreted with both Christmas and New Years but will be tracking new hospital admissions 2. 24 States did not report yesterday on critical pandemic parameters and will cause a surge in cases and fatalities due to this reporting issue in the next few days 3. Summarizing the current state of the pandemic : overall the USA is at a high plateau for cases and hospitalizations and due to lagging fatalities reporting in improving states we won't see the fatality plateau until the next 2 week s Some areas going done and others are still surging. Big question will be whether we will have a post-holiday (Christmas and New Year surge). Letter from VP Pence - December 18 Photo with VP Pence - December, 2 Raising concern about what Trump might do as a last-ditch effort to prevent Biden from assuming the Presidency. He is already calling for demonstrations in Washington at the time of the January 6 ratification of the electoral votes by the Congress. He could induce riots and then invoke martial law to “control” the riots. Also, he could not sign the Omnibus budget bill and cause a government shutdown that could interfere with the inauguration PRESS: CNN State of the Union with Dana Bash; The Guardian: Interview 'New disease, no treatment, no cure': how Anthony Fauci's fight against Aids prepared him for Covid-19 Benjamin Ryan December 28, 2020 – Global – 79,900,000/1,800,000; USA – 19,100,000/332,200 POTUS changed his mind and signed the Omnibus budget bill avoiding a closure of USG. Spoke with Deb. This AM (this is one of many early morning 6:00 AM calls that I have with her just to check in and schmooze about what is going on. She is concerned (probably correctly so) that the Biden people think that there is some COVID-19 response structure here and there is not. There is her and backup from CDC and she railed on about how bad the CDC is (I agree with her in part). She feels that they completely blew COVID-19 by acting like it was influenza and they plugged in the “syndromic” model where you follow and test only those who are symptomatic since it took them forever to admit that COVID-19 was spread symptomatically and was very much different from influenza. PRESS: Taped podcast with ABC Jonathan Karl for later viewing; December 29, 2020 – Global – 79,900,0900/1,800,000; USA – 19,200,000/334,000 NEWS CLIPPING — BLOOMBERG — CONDENSED (2 SOURCE PAGES) “1.Most concerning are where COVID admissions are rising now showing significant community spread just prior to the Holidays and could have the most significant post Holiday surge – this is TX, GA, SC, NC, WVA.…” % Mentioning Number of top 10 finish Bill Gates 1 21 LeBron James 1 1 Dalai Lama 1 11 Combined first and second mentions; rankings based on total number of responses GALLUP, DEC. 1-17, 2020 December 30, 2020 – Global USA General Gus Perna asked to speak with me this Am (7:30 AM) for advice and “comfort”. There has been criticism about the roll-out of vaccines. @0 million doses were promised by the end of December and we only have 11 million. Also, only 2-3 million have been administered (the latter is not his responsibility). He realizes that there is disappointment and wants advice. I told him that above all he needs to be transparent and honest and not try to coverup any deficiency. This is a big operation and he should expect bumps in the road. He bemoaned that on the battlefield when he was on the radio he could tell from the background sounds and the “vibes’ on the radio how the battle was going. With vaccines, even on conference calls, he really cannot get a good feel for what all the players are doing and how honest they are being. He does not trust Pfizer; he thinks that they keep moving the goal posts. He likes Moderna. He was very grateful for the call. Senator Marco Rubio is acting like a real asshole. He is publicly calling me a liar about my statement in the NY Times about my assessments for the percent vaccinations needed for herd immunity. I had said that I modified my assessment of 70 to 75% to be 70 to 85% because we really did not know the precise number and I wanted to encourage people to get vaccinated to achieve herd immunity. Actually, I made that change by extrapolating the measles situation where measles vaccine is 98% effective whereas SARS-CoV-2 is 94-95% effective. Measles begins to lose herd immunity at around 89-90% of population vaccinated and so I brought up the SARS-CoV-2 to 85% with the range being 70 to 85%. For that he called me a “liar” Big hypocrite as he continues to kiss Trump’s ass – the world’s biggest liar. “Sen. Marco Rubio: Dr. Fauci lied about coronavirus — I am appalled by his arrogance” Placing blind faith in unelected celebrity scientists has its limits, and we must not be afraid to call them out By Sen. Marco Rubio | Fox News Had 2nd conversation with Rochelle Walensky where I am advising her on her new position as CDC Director. I briefed her on the fact that as good as some of the CDC people are, as an institution they have hubris and are often incorrect. She needs to follow her good instincts and question what they are doing in a friendly, non-threatening manner. PRESS: WTOP Special Radio with J.J. Green; UK TimesRadio interview; C-SPAN TV interview with Gov. Newsom of California; MSNBC “The Last Word” with Lawrence O’Donnell December 31, 2020 – Global – 81,500,000/1,800,000; USA – 19,700,000/341,200 1. Most concerning are rising case counts during a dramatic decline in testing – CA, TX, FL and where COVID admissions are rising consistent with significant undetected community spread prior to the Holidays and potentially the most significant post Holiday surge – this is FL, TX, GA, SC, NC, WVA. 2. New admissions rising in OK, TX, AL, MS, GA, FL, NY, MA, WVA, KY High Plateau in CA, AZ, NM, AR, TN, MD, CT, NJ 3. States with the most hospital staff stress are those states in the dark red zone and still rising – CA, AZ, GA and those states in the red zone and still rising – OK, TX, MS, AL, SC, TN, DE, NY 4. The Coasts (80% of the population) are now driving the increasing cases, hospitalizations and deaths. Mackenzie Miller (Daughter of Katie and Stephen Miller) admitted couple days ago first to Georgetown Hospital and then transferred to Children’s National. Developed acute onset of unresponsiveness. Improved significantly on IV fluids and antibiotics and acyclovir. Baby (6 months old) exposed to grandmother who has cold sore and so HSV encephalitis suspected. MRI (brain), EEG, physical (some hyporeflexia) all OK. Have spoken with her ID physician Reinhard Wiedermann and will speak with neurologist Elizabeth Wells. Am on phone frequently with Katie and Stephen. PRESS: NBC Today Show with Craig Melvin; WBAL Baltimore Radio; MSNBC with Andrea Mitchell; January 1, 2021 – Global – 81,900,000/1,800,000; USA – 20,000,000/345,000 Records continue to be broken with 125,000 hospitalizations and >3000 deaths. GOP and Trump planning to challenge the January congressional certification of the electoral votes. Disgraceful assault on democracy. • Spoke with Mitt Romney this AM who ran by me an OpEd he wants to submit pointing out the lack of success and weaknesses of the vaccine rollout plan and suggestions of how to improve it. Clearly there is a problem (see below) Problem with vaccine rollout. Plan was to have 40 million doses delivered by December 31 with 20 million in the arms and 20 million in reserve. This far 14 million delivered and 2.7 million in the arms. Clearly, they need to catch up. There is no central “plan” similar to no plan for testing and no plan for PPE. 1. Most concerning are rising case counts during a dramatic decline in testing – CA, TX, FL and where COVID admissions are rising consistent with significant undetected community spread prior to the Holidays and potentially the most significant post Holiday surge – this is FL, TX, GA, SC, NC, WVA. 2. States with the most hospital staff stress are those states in the dark red zone and still rising – CA, AZ, GA and those states in the red zone and still rising – OK, TX, MS, AL, SC, TN, DE, NY 3. The Coasts (80% of the population) are now driving the increasing cases, hospitalizations and death January 2, 2021 – Global – 82,400,000/1,800,000; USA – 20,100,000/347,000 Deaths now averaging around 3000 per day. Hospitalizations continue to break records. Trump totally focused on disrupting the transfer of power and declaring the election invalid. Big day coming up on January 5 when the Congress certifies the Electoral Votes. January 3, 2021 – Global – 82,600,000/1,800,000; USA – 20,300,000/350,000 Data remains unstable but early signals are increasing test positivity (49) states and in some states rising cases – tracking closely. Concerned about upcoming post-holiday surge 1. Reporting remains unstable and will create this current valley and peak (slide ¾) due to reporting alone – watching slope of rise. 2. Testing is down 40% over the past 7 days creating a high admission rate/case across all age groups and any increase in cases concerning 3. 49 states have rising test positivity and 17 rising cases despite reporting issue – this normal precedes a significant surge is hospitalizations Total deaths have not reached 350,000!! Tweet from Trump: Got a call from Jeff Zients wanting to confirm the I still am in favor of Janet Woodcock for FDA Commissioner. He was getting some negative signals from some people that she was involved in the EUA for hydroxychloroquine. I explained to Jeff that this was really Mark Meadows pressuring Steve Hahn who caved in. PRESS: ABC “This Week” with Martha Raddatz; NBC “Meet the Press” with Chuck Todd; January 4, 2021 – Global – 83,700,000/1,800,000; USA – 20,600,000/350,700 Expecting the post-holiday surge 1. I have included the European data in slides 3 and 4 – most of the European increases being driven by the UK 2. You can also see from slide 3 the rate of rise of our Fall/winter surge was more dramatic consistent with the USA having its own more infectious variant Things starting to move with my involvement with the Biden team. Biden is concerned about making sure that he reaches 100 million doses of vaccine in the 1st 100 days. We are meeting by zoom with him tomorrow and today and tomorrow we had/will have pre-brief meetings to discuss our plan – led by Jeff Zients. Present were Natalie Quillian, Vivek Murthy, Marcella Nunez-Smith, Rochelle Walensky, David Kessler, Asma Mirza, and Sonya Bernstein. Plan is to develop community vaccination centers, use mobile units to get to rural areas, etc. Nursing staff in the OR at the Brigham and Women’s Hospital all wearing Fauci caps. Email sent to me by Atul Gawande. PRESS: Did zoom interview with the Newsday Editorial Board; MSNBC “All In” with Chris Hayes January 5, 2021 – Global – 84,200,000/1,800,000 USA – 20,700,000/352,000 Deb’s notes: Made this shorter to make serious points. First and foremost our Fall surge slope is nearly identical to the UK slope suggesting we have had our own more transmissible strain since then and it was responsible for the Fall surge in the Northern Plain states. My concern then was this type of surge moving into the more populous states as it has now in CA and now Tx and the sunbelt is unstable as well as the midAtlantic and NorthEast. Viruses are always in search of escape mutants than are more transmissible yet preserving replication capacity. This is happening around the globe and the immunologic pressure on viruses drive this potential and we continue to increase the immunologic pressure through percent of population infected, use of plasma and monoclonal Ab and now immunization. Key to RNA viruses with this of high mutation potential is to rapidly immunize the population especially those most likely to have high replication potential – those over 65. We have to accelerate the immunization of those over 65 ASAP. We can’t hold back on the rest of Tier 1 awaiting 1a. We have been in 1a for a month without adequate progress. Deb Trump going completely crazy. Was recorded on an hour-long telephone call with Secretary of State of Georgia Brad Raffensperger to change the votes and asked for 11, 780 votes to be changed (he lost Georgia by 11,779). Clearly a criminal act of trying to influence an election. More cowardly GOPs are backing Trump in the House Kevin McCarthy (R-CA) and Senate (Ted Cruz (R-TX) and Josh Hawley (R-MO) • Big discussion and debate in the press about whether to give more single doses of vaccine and wait few months before the second dose. The UK is doing this with the AZ vaccine. There is no scientific data to justify this. They are doing it because they want to give more people first doses. Our problem is not more people than doses, it is that we are not injecting as many people (4 million) with the doses that we have (14 million). Much discussion in the press about this. • Had Zoom meeting with Biden and Harris. Meeting led by Jeff Zients. Present was Ron Klain, Natalie Quillian, Marcella Nunez-Smith, David Kessler, Vivek Murthy, Rochelle Walensky, Bechara Choucair. Topic was that Biden wants to announce in a speech 3 transforming steps that he will initiate regarding vaccines. Natalie presented our plan and there was discussions about using pharmacies first and then as we get more doses, opening up “Community Vaccine Centers”. I described status of the outbreak. Biden is much more in favor of federal presence than is the Trump administration. Slide deck is below: Slide Deck - COVID Policy Briefing 1 5.pd PRESS: Interview with Newsweek UK; AP Online interview with Lauren Neergaard; January 6, 2021 - Global – 84,800,000/1,900,000; USA – 21,000,000/356,000 Spoke on chat with Chiefs of Police and with Presidents of Jesuit Schools (led by Fr. Dan Lahart of Regis) Made rounds on COVID-19 patient at Clinical Center. I have been doing this about 1X per week. Saw patient today with COVID disease - 73 y.o. AA male, ex-marine, ex-State Trooper. Says this is worse he has ever felt. • My group (Mascola, Graham, Lane, Marston briefed the ART team led by Lu Borio and Marcella Nunez-Smith and David Kessler. We spoke about the mutant viruses in UK and RSA and their impact on mAbs and vaccines. 1. There is a significant increase in test positivity rate and a high hospital admission rate/case across all age groups 2. I have included the top 10 states for cases and it is a mix of states that were surging prior to the Holidays NY, TX, FL, GA, AZ and states that were improving or stabilzing prior to the Holidays CA, PA, OH, IL, NJ and tracking these states will be key to estimating the impact of the Holidays on cases and eventually hospitalizations The Fall surge in the Northern Plain states was more aggressive and we warned if this type of surge hit populous states this would threaten the health care system – this is what we are seeing in CA and to be clear this is spreading across the Sunbelt and into the North East. Trump incites riot as protestors storm the Capitol, break windows and occupy Pelosi’s office. Capitol Police utter failure to control them. Democrats take both Senate seats in Georgia Election - Jon Ossoff and Raphael Warnock. Biden electoral votes certified by Joint Session of Congress. Sens. Hawley and Cruz fight to the bitter end to their shame. Several senators who originally had supported the attempt to overthrow the election have changed their mind because of the shock of the storming of the Capitol PRESS: Podcast Fireside Chat with David Rubenstein for the Economic Club of Washington, DC; BNN Bloomberg Canadian TV; January 7, 2021 – Global – 85,500,000/1,900,000; USA – 21,300,000/360,000 Record number of deaths yesterday - >3963. Today another record at 4000. Surging continues. Slow start in the implementation of administration of vaccines. Was supposed to have 20 million doses distributed and administered by December 31. Today there have been 15 million distributed and 5 million administered. PRESS: NPR – “Morning Edition”, Noel King; France24 TV (Arabic language); WJLA TV; New York Times: NYT: Fauci says he thinks that January will get worse, and that the vaccination effort needs more time. January 8, 2021 – Global USA 4111 Deaths!! Record hospitalizations. I have been on the phone with Jeff Zients a few times today. I checked the number for projected requirement of vaccines to fulfill the promise of 100 million doses in arms in 1st 100 days of Biden administration. The number in the Biden slides (Kessler derived) was 275 million doses and 135 million people (getting 2 doses) by end of April. I called Moncef Slaoui and got the actual numbers and they totaled 189 million. I called Jeff and let him know. He checked with Kessler who then checked with Moncef and they figures that the doses that had already been allocated prior but not given yet would make up for the difference. I am concerned that we (Biden team) will not meet the promise. Too many vicissitudes in vaccine production. Perhaps Janssen will bale us out with the 25 million doses in March and 40 million in April (single dose required). Then, Biden team announced that they would not hold back any doses to save for 2nd shot, but will immunize everyone then can with doses they have. This places a lot of faith in the precision of the production/delivery of doses. They may have to pause with 1st doses to catch up with 2nd dose requirement. At 8:00 PM tonight as I was over Rob and Ellen’s “open Garage” dining room, Jeff Zients called me again asking for a favor. A Politico reporter is already getting ready to write a story spreading rumors that Biden is upset with his COVID team and Jeff is asking a favor for me to go on “background” and tell the reporter that they are doing a very good job. I told Jeff that I would of course be happy to do this. PRESS: NPR International – “The World”; C-SPAN doing “Facts and Faith” at VCU talk with Virginia Governor Northam. Speaking to Black Faith leaders January 9, 2021 - Global - 87,600,000/1,900,000; USA – 22,000,000/368,000 The pandemic is getting more scary. Every day more and more cases and deaths. Patients in the hallways in California. Nurses and MDs exhausted. It seems that people are getting infected who are being careful and have no idea why they are getting infected. N501Y mutation is here in the USA, but it is not dominant. We may actually have out own mutant that we have not recognized since the CDC has not really been looking. NEWS CLIPPING — POLITICO — CONDENSED (2 SOURCE PAGES) “Had conversation this AM 12:10 PM to 12:50 PM with 2 reporters from Politico (Adam Cancryn and Tyler Pager). Call set up by T.J. Ducklo (see note about regarding call from Jeff Zients). See above…” historical record of A.S. Fauci – Part 3 January 10, 2021 – Global – 88,400,000/1,900,000 USA – 22,100,000/371,100 And the surge goes on….. There is a real concern that we have our own mutant that is resulting in an increased surge in cases. People are saying they have no idea how they got infected since they have been observing public health recommendations. See below comments from Birx. After Thanksgiving the Northern Plains MN, IL, MI held and did not significantly deteriorate. In contrast this current post Holiday surge is causing deterioration in all metros including metros that were stable and metros that did not experience a significant post Thanksgiving surge. NYC has returned to case counts equal to the Spring recognizing we are testing at much higher rates but this surge is just beginning in NYC and with this current rate of rise of cases could drive significant cases, hospitalizations and deaths especially if it deteriorates at the rate of LA. Proactive setting up of infusion sites now is critical in all large metros and active immunization of those over 65. We have enough vaccine in the States to immunize nearly 15M senior which would be nearly 25% of all seniors over 65. We need to treat this current situation as the emergency it is. Deb Deb’s report: 1. Reporting has stabilized and we have returned to the pre-thanksgiving rate of cases as the current resurgence moves into the populous states from CA to TX to FL and resume a full log phase rate 2. EVERY METRO over 500K residents is deteriorating except Honolulu. - even those that had been stable now have rising cases slides 6-52 : NYC area is now reached cases greater than the Spring surge 3. All of the most populous states are deteriorating or continuing to deteriorate – CA, TX, FL, NY – only CA maybe showing signs of reaching a high plateau – TX, FL, NY will become the new epicenter of this surge over the next 3 weeks – I believe we have had our own evolved and more transmissible strain or strains since September by reviewing all the epidemiologic data – this fall/winter has a more rapid rate of rise from the beginning which predated Thanksgiving and continues at the rate post the Holidays (slide 3) – this rate of rise is now independent of the weather as it is occurring across the South, LA, etc - the surge is more difficult to mitigate - which will require more aggressive action to control and all actions need to be taken now to flatten this curve and preserve the health system) Normally the weekly high for fatalities is Wednesday – deeply concerning that both Weds Thurs and now Friday have deaths near 4000/day See graphs on slide set below (frightening): 10Jan2021DataSum mary.pptx Major discussion among Congress in invoking the 25th Amendment to remove Trump. Pelosi is going to go ahead with impeachment proceedings even though there would be no time to convict, they can impeach. Several people in the White House and Cabinet are resigning – Elaine Chao, Matt Pottinger. POTUS is attacking Pence for not going along with his attempts to overthrow the election. Poor Pence. He had been so loyal, but I am pleased to see that the goodness that I recognized in him is coming out, albeit a bit late in the game. The crazies in the Trump following are calling for the execution of Pence, similar to Crazy Steve Bannon calling for my beheading. PRESS: WGN Radio (Steve Dale) – Chicago; Satire from The Borowitz Report Fauci Says Immunity from Trump Requires Two Doses of Impeachment By Andy Borowitz January 11, 2021 – Global – 88,800,000/1,900,000; USA – 22,300,000/373,200 Surge continues unabated. Deb’s notes: 1. Reporting has stabilized and we have returned to the rapid prethanksgiving rate of cases as the current resurgence moves into the populous states from CA to TX to FL 2. Nearly all METROs over 500K residents is deteriorating. - even those that had been stable now have rising cases slides 22-26: NYC area is now reached cases greater than the Spring surge 3. All of the most populous states are deteriorating – CA, TX, FL, NY – only CA maybe showing signs of reaching a high plateau – TX, FL, NY will become the new epicenter of this surge over the next 3 weeks – as viruses evolve and strains are imported– the fall/winter has a more rapid rate of rise predating Thanksgiving and continues at the rate post the Continued discussion about invoking the 25th Amendment. Trump have been permanently banned from Twitter and at least temporarily from Facebook (maybe permanent). Trump stating that “it is only beginning”. Intelligence chatter indicating that there will be massive demonstrations and even violence associated with the inauguration. Mick Mulvaney made some interesting comments on a CNN Special on “insurrection”. When asked why so many people stuck with Trump when all the signs were there that he was acting crazy. Mick said that when you lie with him in the WH day after day, you see that he has accomplished a lot and you tend to downplay in your mind the signs of craziness. I even saw some of that during the time that I went to the WH every day for months in the Spring and Summer. Marc Short called me and asked for me to make connection with the Biden people and invite someone to today’s Task Force Meeting so that the Biden Team can get a feel for how the current task Force works. I called Jeff Zients and Jeff gave them Cyrus Shahpar who is on the Biden team and works for Tom Frieden. Did a chat with Bishop TD Jakes including Kizzy Corbett. Trying to Spoke with Pat Foye of the Metropolitan Transportation Authority (MTA). They want me to do a 1 minute PSA to encourage their employees to get vaccinated. PRESS: Rural TV Network – “Rural Health Matters”, Nashville, TN TV; POLITICO: ‘There is a palpable concern’: Biden presses advisers over 100 million Covid shot goal (This relates to my conversation with Zients/Ducklo) CDC: No sign of homegrown U.S. coronavirus variant, but scientists need to look harder By Joel Achenbach, Kim Bellware and Hamza Shaban January 12, 2021 – Global – 89,400,000/1,900,000; USA – 22,500,000/375,100 4400 deaths today John Mascola working with David Ho to determine the possibility that the UK (N501Y; B.1.1.7) and/or the RSA mutants evade the antibodies induced by vaccines. According to Ho, the RSA mutants are much more troublesome in that they do not eliminate the protection of vaccine induced antibodies, but they definitely decrease by 2 to 3-fold their potency. David is now working on studying the UK mutant. Stay tuned. The next 4 weeks will be determined by whether the large Southern, upper Mid-West, Mid-Atlantic and North-East metros will be able to contain the rapid accelerating viral spread or have the prolonged log phase followed by the high plateau of LA (now entering month 3). Deb 1. Reporting has stabilized and we have returned to the rapid pre-thanksgiving rate of cases as the current resurgence moves into the populous states from CA to TX to FL : cases are up 7% from last week's same time period. 2. Nearly all METROs over 500K residents is deteriorating. - even those that had been stable now have rising cases slides 7-45: NYC area is now reached cases greater than the Spring surge Throughout “the 2019 flu season from Sept. 29 to Dec. 28, the CDC reported more than 65,000 cases of influenza nationwide,” while “during the same period last year, the agency reported 1,016 cases.” • Had discussion with Chris Whitty and Patrick Vallance of the UK regarding their mutant and their vaccine program. They confirmed that the mutant is spreading widely in UK and other EU countries and also that there is no increase in virulence of escape from vaccine-induced antibodies. They also mentioned that they are more concerned about the RSA variant (mutants). • Did Fireside Chat with Barbara Bush on “Future Forum for Preparedness” (her Global Health Corps) Had discussion with Azar, Pence, and the OWS crew about vaccine rollout. We will as of tomorrow (announce at the Governor’s call) that we are changing our rollout strategy. We are going to be more flexible and not strictly wedded to the ACIP/CDC guidance of Phase 1a. We should continue that, but move on the people >65 years old and people 16 (or 18) to 64 with underlying conditions Am communicating with Stanley Tucci. He has heard through the media that I make Tympani: From: Stanley Tucci <sta914@gmail.com> Sent: Tuesday, January 12, 2021 2:28 PM To: Fauci, Anthony (NIH/NIAID) [E] <afauci@niaid.nih.gov> Cc: Lottie Birmingham <lottie.birmingham@icloud.com> Subject: Re: Stanley Tucci and Timpano Dr. Fauci, Thank you so much for your timely response and your kind words. The books will be whisking their way towards you imminently. It is my hope that someday we might prepare and enjoy a Timpano together. All the best to you and your family. With great respect and admiration, Stan On 12 Jan 2021, at 6:54 pm, Fauci, Anthony (NIH/NIAID) [E] <afauci@niaid.nih.gov> wrote: Mr. Tucci: Thank you for your very kind note. I was thrilled to hear from as I am a great fan of your acting and am looking forward to watching your CNN Special. I would be honored if you could send me autographed copies of your cook books. My address is 3012 – 43rd Street, NW; Washington, DC 20016. I hope that you are doing well during these difficult times. Please stay safe. Warm regards, Tony Jeff Zients called me to get approval of a statement that Biden will put out criticizing the Trump administration for opening up the floodgates of the Phases for vaccines (see above) given that there is not enough vaccine to go around at this point. Indicated that I did not like the statement sine it was a gotcha. Jeff did not like that but nonetheless changed it somewhat according to my suggestions. Here Are 18 Celebrities (And Public PRESS: Figures) Who Have Gotten The Coronavirus Vaccine From politicians to performers. by Matt Stopera BuzzFeed Staff January 13, 2021 – Global – 90,100,000/1,900,000; USA – 22,700,000/379,000 The surge continues. Could this be that we are dealing with our own highly contagious variant, but we do not realize it since the CDC sequencing surveillance has not been very comprehensive as has the UK surveillance? See below 1. Reporting has stabilized and we have returned to the rapid prethanksgiving rate of cases as the current resurgence moves into the populous states from CA to TX to FL : cases are up 7% from last week's same time period, as CA improves, the high population states of TX and FL will surge and the fatalities will increase, many states are reaching 0.2% rates per population deaths 2. Nearly all METROs over 500K residents is deteriorating. - even those that had been stable now have rising cases slides 15-18: NYC area is now reached cases greater than the Spring surge Trump impeached for 2nd time! Several Republicans vote in House for impeachment. Unlikely to come to trial in Senate until after inauguration. Biden does not want distraction from his 100 days agenda. Had zoom call with President of Ecuador – President Lenin Moreno Garces. We discussed the situation in Ecuador, vaccines and a whole bunch of questions that he had. Seems like a very smart person. I promised to advocate for equitable availability of vaccines throughout the world including Ecuador. Had Zoom call with Biden team – (Marcella Nunez-Smith, David Kessler, Rochelle Walensky, Vivek Murthy, Connolly Keigler and Maju Varghese). David led discussion regarding the inauguration. Originally there was supposed to be 250 people on the platform 6 feet apart ()POTUS and VP and Family, supreme court justices, leaders of Congress. 6 feet apart, all masked, all tested. Then then wanted 29,000 on the West Front. Maju Varghese was operationally responsible for arrangements. These 29,000 were cut down to 2000 by David (who is overall responsible for arrangements). The meeting today was to determine if we were OK with this. We all (Marcella, Rochelle, Vivek) voted that there should be no one on the West Front. I made the argument that some of the GOP Congressmen could make trouble by not wearing masks the way they refused when the Capitol was attacked and they were crowded in a room. Also, if someone gets infected, the press will jump on us. David will bring this back to Biden and Klain. Had regular every 2 weeks call with Bill Gates – Bill and Trevor Mundel know about the issue with the mutations that David Ho is working on. We discussed working together to track them as well as using Gates money to jump-start the development of mRNA vaccines to match the mutations (B.1.1.7 variant) with the N501Y mutation. We need to be ready to respond Front Page Story of Italian Magazine “I Love Sicilia” SKM_C754e2101131 7230.pdf Some Black Muslims accusing me of trying to experiment on Blacks. He mistakenly (deliberately) is ignoring that I, Pence, Biden, Harris have all gotten vaccinated. He is saying that Blacks would be the herd immunity that would protect whites: Beyond Tuskegee: Targeting of Black people for Covid-19 vaccine By Anisah Muhammad, Contributing Writer On January 10, Student Min. Muhammad, a researcher, scholar and author, delivered the Nation of Islam’s Sunday address at Mosque Maryam, titled, “Beyond Tuskegee: Why Black People Must Not Take the Experimental Covid-19 Vaccine.” “Why beyond Tuskegee? The vaccine mafia who want Black people to be the first injected with this experimental vaccine have centered the Tuskegee experiment in their narrative, most prominently Dr. Fauci. Let’s say we get 75 percent, 80 percent of the population vaccinated,” Dr. Fauci said on Dec. 9. “If we do that, if we do it efficiently enough over the second quarter of 2021, by the time we get to the end of the summer, i.e., the third quarter, we may actually have enough herd immunity protecting our society that as we get to the end of 2021, we can approach very much some degree of normality that is close to where we were before.” As of July 1, 2019, the U.S. Census Bureau reports that 76.3 percent of Americans are White. Bob Woodward came to my house tonight to deliver the transcripts of the tapes of his interviews of me for his book “Rage”. He said that it would help me with the writing of my book, He really wanted to come over and tape an interview with me about my current dealing with Biden. I explained the interactions with Biden (see above). Nothing controversial; however, it was clear why he wanted to come over. He is writing yet again another book. We met outside in the cold due to COVID-19 I wrote a belated birthday note to Joan Baez (her birthday was Jan.9, 1941). I had forgotten due to recent events at the Capitol, and so I wrote her a note apologizing. She wrote back: “Of course I accept!. There was a postcard circulating in Frace under a liberal administration in the eighties, “nous sommes tous dans la merde”. We are all in the shit. I don’t speak French anymore, but the post card stands out. Yes, we are the same age! You are a rock star and I am a badass, and age is very much beside the point. Thinking of you. Joan” PRESS: WPIX TV New York City with Dan Mannarino; Children’s Hour Public Radio; WMBD radio and WYZZ TV (Central Illinois); The Children’s Hour Public Radio; January 14, 2021 – Global – 90,800,000/2,000,000; USA - 23,000,000/383,400 Note from David Ho. Mutants are becoming very troublesome: Here is an overview first. Will share detailed organized data in a couple of days. I am available to chat at a mutually convenient time. Patrick Vallance from the UK is reaching out to me to get preliminary results as well. We have constructed SARS-CoV-2 pseudoviruses that contain all 8 mutations in the UK variant and all 9 mutations in the SA variant. In addition, we have also constructed pseudoviruses that contain each of the 16 mutations (501Y mutation is shared) individually. This entire panel has been tested on a collection of ~30 spikespecific neutralizing monoclonal antibodies, 20 convalescent plasma, and 18 vaccinee sera (Moderna and Pfizer). First, both UKdelta8 and SAdelta9 showed increased replication capacity in vitro, which is consistent with their increased transmissibility in vivo. Overall, the impact on virus neutralization is profound, with the SA variant being worse than the UK variant. It is quite clear that these two variants could now resist several classes of neutralizing monoclonal antibodies already used in the clinic or still in development, and in most cases we understand which of the mutations are conferring the resistance. This information is particularly relevant to companies like Lilly and Regeneron, which have approved clinical products that are severely affected by these results. In addition, a large majority of convalescent plasma samples showed an appreciable loss in activity against the new variants, suggesting re-infection may be more likely when confronted with either of these two strains. Finally, we also observed a significant impact on vaccinee sera in that every serum sample tested showed a substantial loss in neutralizing activity against the SA variant, whereas the loss in activity against the UK virus is not as large or as universal. Again, we believe the latter findings should be shared promptly with the field, because these new strains threaten the effectiveness of the current vaccines. Importantly, the strategy that the UK is now contemplating (giving one dose and delaying the second dose) is quite dangerous in that one or two additional critical mutations on top of either strain (under suboptimal antibody concentrations induced by one shot without a booster) could render current monoclonal antibodies and vaccines useless. Our data are germane to that debate. Our data are more or less complete, except for live virus neutralization results. We are still waiting for the UK and SA to be distributed by the US government to our lab. We expect to have the live viruses soon, and could generate the confirmatory results in about 7-10 days after receiving the viruses. • Received the Ken Shine Prize in Health Leadership from the University of Texas at Austin Dell Medical School • Briefed the Congresssional Blue Dog (moderate Dems) and Moderate GOP members led by Rep. Stephanie Murphy (D-FL) and Rep John Katko (R-NY) • Met with Rep. Espaillat (D-NY) who want me to meet with a contingent from the Dominican Republic. I will do so, but after the inauguration • Got call from Beth Cameron (NSC) informing me that Biden want me to be the Head of WHO delegation and to announce on January 21 (4:10 AM ET) that the USA is back in the WHO. • Biden give big speech (7:15 PM) announcing $1.9 trillion budget package including $415 Billion for COVID response PRESS: KSEE24 TV (NBC Affiliate in Fresno, CA) January 15, 2021 – Global – 91,500,000/2,000,000; USA – 23,200,000/387,300 Had Zoom briefing of Biden and Harris to prep them for the speech that Biden will give at 3:45 PM on the vaccine rollout plan. We briefed him at 2:30 to 3:30 and he and Harris (only he spoke) gave briefing to the Nation. Biden announced today that he has asked Francis Collins to stay on. I had some influence on this. Eric Lander will be head of OSTP. Considerable concern about the new mutants in UK, Brazil and especially South Africa – David Ho is studying this carefully and finds that the UK variant results in a 2-fold decrease in ability of vaccine-induced antibodies to neutralize. For the South African variant it is 4 to 5-fold decrease. Had Zoom with David and John Mascola and others and David went over the Mutant data. Bottom line is that against the UK mutant the vaccine (Moderna)-induced sera is weakened by 2-fold; however, against the RSA (and by extrapolation although did not look the Brazilian) mutant the sera are diminished by 5-fold) MAJOR IMPLICATIONs for vaccine development and for policy such as letting people into the country PRESS: Ebro in the Morning Radio Show in NYC; Today Show NBC TV with Craig Melvin; CTV - Canadian TV – Sunday Show (Ian Wood); WUSA TV Jan Jeffcoat; January 16, 2021 – Global – 92,300,000/2,000,000; USA – 23,400,000/391,000 Jeff Zients gave me the entire Biden plan to look at and approve - I mentioned to him in detail the recent data from David Ho. We will set up a call for Sunday with the Biden team (doctors) since now several teams such as Michel Nussenzweig, Jess Bloom and others are finding the same thing as Ho. I want the call on Sunday since Michel is publishing his data in BioRx on Monday. I will bring John Mascola on the call with me to describe with some slides. Also, I have pushed with JZ to get Ned Sharpless re-appointed as NCI Director otherwise his resignation letter will go into effect on January 20. I asked JZ to get in touch with Ron Klain and re-appoint hi. JZ called me back this evening and said he spoke to Ron and Ned will stay as NCI Director. Post-holiday surge seems to be stabilizing. See Deb’s comment below: 1. For the first time in weeks all indicators except fatalities are flat or declining. This suggests with full data triangulation that we have reached in most of the country the post Holiday peak and declines should continue to follow with continued mitigation. Testing rates have resumed to pre Holiday levels as for the first time week over week cases have declined (SLIDE 4) from last week's high – but testing for asymptomatic cases must increase to sustain the gains. Finding the containing the silent spread will be key to holding the current gains 2. CA is stabilizing at a high plateau and if AZ, FL, TX, NY can hold at their current plateau or early declines we could see National improvement beginning next week and improvement in fatality rates in 30 days but not without reaching 450K in 4 weeks and 500K fatalities over the next 8 weeks based on current case load and rate of rises 3. Most of the rapidly rising metros appear to be reaching peak or at a high plateau and some like Chicago and NYC are beginning to decline. The key will be continued aggressive mitigation 4. New COVID hospital admissions are stable at a high plateau nationally but if the larger states and metros can hold or improve the rates should steadily decline if we can keep everyone focused on vigilance as we vaccinate PLEASE SEE SLIDE 3 SHOWING ICU BED OCCUPACY – SHOWING CLEARLY THE PRIMARY CURRENT STATES WITH THE WINTER SURGE PRESS: January 17, 2021 – Global – 92,300,000/2,000,000; USA – 23,700,000/395,000 We may have reached the peak of the surge upon a surge 1. For the first time in weeks all indicators except fatalities are flat or declining. This suggests with full data triangulation that we have reached the post Holiday peak in most of the country and declines should continue with continued mitigation. These gains can be sustained and can accelerate if behavior change holds 2. Test positivity is declining. Testing rates have resumed to pre Holiday levels as for the first time week over week cases have declined from last week's high – but testing for asymptomatic cases must increase to sustain the gains. Finding the containing the silent spread will be key to holding the current gains. 3. Cases are declining or stable across the country (down 8.8%) • John Mascola and I presented to JZ and the Biden medical team the results from David Ho’s work on the UK and RSA mutants. (see above). We explained that this requires careful messaging since people would interpret incorrectly that this nullifies the vaccine which it does not. JZ has tasked me to write a 2-paragraph description to send to Biden tonight. I did so and now we have a meeting tomorrow AM to discuss possibility of travel restrictions from RSA and Brazil. PRESS: Meet the Press (NBC) with Chuck Todd; Che Tempo Che Fa Italian Sunday TV Show; MSNBC Lawrence O’Donnell January 18, 2021 – Global – 94,000,000/2,000,000; USA – 23,800,000/397,000 Zoom meeting at 7:30 AM with JZ and the team + Jake Sullivan – discussed the restrictions on travel to RSA, Brazil and perhaps other countries. Leaning towards requiring PCR 72 hrs before board to USA followed by Ag test upon boarding followed by Ag test within 3 days of landing + quarantine. Will present to Ron Klain and POTUS after inauguration. Deb Birx’s next to last TF note: This is the last metro case analysis. We are seeing mostly significant improvements or major metros holding at a high plateau. I am worried about the 12 metros that are still increasing and one of them is DC. I walked some of the areas downtown on Sat while I was moving out of my State Dept office and there are major feeding tents set up around downtown for the workers and National Guard – these can be super spreading locations and the National Guard is from around the country including hotspots. National Guard troops must be tested and must be tested when returning but I worry we are creating a massive viral spreading event as troops deploy to DC and then return home and the co-mixing of local metro police with National Guard. That said by all indicators we are stabilizing as a country and improvements should continue. New hospital admissions are down across the country and is super spreading events can be managed we should continue to see improvements as more states will be able to utilize health personnel to support massive vaccination. On the personal level getting the elderly – the highest risk group over 75 - immunized is incredibly difficult. We have the entire family working to secure sites for my parents but you need to be tech savvy and able to constantly refresh sites and search multiple county and state websites. Then you have to be able to transport and move them to the vaccine sites. We think we may have secured a PG county option for this week but if elderly do not have tech support or outreach and transportation support this will be incredibly difficult for them. Deb 1. For the first time in weeks all indicators except fatalities are improving and are either flat at a high plateau or declining over 7 days. This suggests with full data triangulation that we have reached the post-Holiday peak in most of the country and declines should continue with continued mitigation. These gains can be sustained and can accelerate if behavior change holds and testing increases to find the asymptomatic cases to prevent community spread Had farewell conversation with Vice President Pence. I called up Marc Short to ask him to have the VP call me today since I was not sure that I would be able to attend (virtually) the last TF meeting this Tuesday. The VP called and we had a very touching and person discussion saying how much he respected me and how the TF would not have been able to accomplish what it did without me. He was very touched. I told him how important it was for his legacy that he acted with such dignity and resolve over the last days when he refused to go along with Trump’s attempt to get him to overthrow the election results. WE parted by saying we will always be there for each other. Received material from Beth Cameron for my announcement on early AM of Jan. 21 that we will re-join the WHO. I will edit it and get it re-approved. Very nice that I have been chosen to be head of delegation to the WHA in Geneva (virtually) to make this announcement. Summary of some events over past few days/weeks: Jeff Zients calls me multiple times per day checking facts, etc. I brought up to him that it would be a good idea for continuity that he keep on Francis as NIH director since if he does not act to tear up the required letter of resignation, Francis automatically is gone and we have an acting (which would not be bad since Larry Tabak is great). Ned Sharpless is in the same boat as presidential appointee at NCI. And so I mentioned to Jeff that we should keep Ned on and he made it happen. And so, in fact I am responsible for keeping the NIH and NCI Directors in their jobs. A surprise is that Harold Varmus called me up and expressed great concern that Francis was staying on. He said many substantial members of scientific community (Bruce Alberts, Shirley Tilghman, etc) are quite concerned and feel that it is time for a change. I explained to Harold that this was probably temporary and related to need for continuity related to COVID-19 efforts. He is trying to get momentum to have this reversed. Harold has always felt that change is important PRESS: TNT “The Arena” with Cari Champion; January 19, 2021 – Received booster dose of Moderna vaccine today together with Francis Collins and Alex Azar. Said goodbyes to Alex and Brian Harrison (his COS). Alex described how terrible it was dealing with the White House people. He specifically mentioned Marc Short. He feels that Marc, Joe Grogan, and Deb. Birx undermined HHS. Deb Last e-mail: 1. The country is in a better place than we have been since before Thanksgiving. All indicators except fatalities are improving and are either flat at a high plateau or declining over 8 days. Monday represents weekend reporting but last night was the lowest case number since the beginning of Nov. Full data triangulation that we have reached the post Holiday peak in most of the country and declines should continue with continued mitigation. These gains can be sustained and can accelerate if behavior change holds and testing increases to find the asymptomatic cases to prevent community spread – we must find those asymptomatic cases to ensure new aggressive variants rapidly spread undetected Last coronavirus Task Force meeting. VP asked Ben Carson to start with a prayer. VP Pence saying goodbye and how proud he is of what the group has accomplished. He read a letter that he is sending to all of us thanking us. He also has chronicled the “accomplishments” of the TF and the government’s efforts. He will send such a letter and the list of accomplishments to Biden. He thanked all of us sincerely and expressed multiple times how much of a privilege it was to work for us. He asked that we help the incoming Biden people in the transition (a little late!!!) Alex Azar warned that their work would be denigrated by the incoming group and their press people, but that is “natural”. Alex delineated everything that he felt we did right. He spoke of our accomplishments in testing, PPE, etc. One would argue about that. Deb Birx spoke about how great it was in working with everyone. She spoke of trust and belief in your colleagues. Wow, this is interesting given how often she threw CDC under the bus and how she and Marc Short were in disagreement on everything, and how she hated Brett Giroir and badmouthed him all the time saying that he always promised more than he could deliver. Brett Giroir praised the VP and said that the VP brought out the best in everyone. VP Pence asked me to say words. I praised him and also praised the VP’s staff. I did not mention Marc Short and Katie Miller, but they knew I was referring to them. Bob Redfield praised the VP as well as Deb Birx. Pete Gaynor explained what a honor it was to work for the VP. VP then thanked a number of people including Jerome Adams, VP staff, Marc Short, Katie Miller and others, Ben Carson, Keith Kellog. VP signed off to a resounding round of applause! PRESS: The PBS Masters people have started filming in earnest for their documentary; interviewed by Adi Ignatius and others for the Harvard Business Review; NYT: As Fauci receives his second dose, he urges Americans to get vaccinated; CNN with Jake Tapper; January 20, 2021 - Global – 94,000,000/2,000,000; USA – 24,000,000/400,300 Inauguration Day! Trump refusing to attend inauguration and left with a flare that was very sparsely attended. Biden was at Mass as Trump flew off to Mar-a-Largo. Trump’s speech was surrealistic talking about all the great accomplishments of his Presidency. He also strongly hinted that he will be back with a “movement”. He is a very dangerous man!! I am preparing for my early AM speech to WHO Executive Board tomorrow. Beth Cameron has given me much leeway on the Speech (which her staff put together). Mutants of SARS-CoV-2 getting much play in the scientific “preprint” arena. Final papers will soon come out. We will put restrictions (requirement for pre - and post - flight testing + quarantine) from RSA. Will brief POTUS Biden tomorrow. Am still quite achy from vaccine booster shot from yesterday. Here are my remarks for WHO tomorrow early (4:00 AM) morning: Remarks of Dr. Anthony S. Fauci at Got a call from Jared Kushner from Air Force 1 on his way to Mar-a-Largo thanking me for what we did with COVID-19 Spectacular Inauguration speech by Biden! Poem by Amanda Gorman was amazing (she is 22 years old). Lady Gaga sang the national anthem; J-Lo sang, as did Garth Brooks. Biden hit the right tone. The speech was in my mind comparable to those of Lincoln, Kennedy, FDR Quotes from speech: “Let us not lead by example of power, but by the power of example”; “We must end this uncivil war” PRESS: Dr. Fauci to lead U.S. delegation at WHO CNBC - meetings as Biden plans to reverse Trump withdrawal Published Wed, 8:41 AM EST Noah Higgins-Dunn@higginsdunn January 21, 2021 – Global – 95,000,000/2,000,000; USA – 24,300,000/405,000 Made speech at Executive Board of WHO (4:00 AM ET) to announce that USA is rejoining WHO. Also, we are rescinding Mexico City Policy. I spoke as representing newly inaugurated President Biden Remarks of Dr. Anthony S. Fauci at Tedros response: WHO Director-General's remarks at the 148th session of the Executive Board 21 January 2021 Thank you, my brother Tony, and welcome to the WHO Executive Board as head of delegation for the United States of America. Thank you, my friend, for your personal support for WHO over many years, and especially in the past year. We have benefited immensely from your participation as a member of our regular global health leaders calls, since the start of the pandemic. And thank you for your incredible leadership against the pandemic in the United States. This is a good day for WHO, and a good day for global health. I send my deep thanks and warm congratulations to President Biden and Vice President Harris, and to the American people. Terrific day! Briefed Biden and Harris in the State Dining Room of the White House. Together with JZ, Natalie Quillian, Rochelle Walensky, Marcella Nunez-Smith. Really relaxed and warm interchange with both Biden and Harris. Then, I went with Jen Psaki and did a press briefing in the White House press room (first time in a long time). They really want me out there and there is no pushback at all for my appearances. CNN went into major panel discussions about the fact that Biden chose me as the first scientific press briefing. PRESS: Did full press briefing in the White House press room. Washington Post article by Philip Bump: Fauci, unchained The government’s leading infectious-disease expert exults in being able to speak frankly Fauci says it's 'liberating' to 'let the science speak' Good Morning America (ABC) with Michael Strahan; CBS Sunday with Ted Koppel; CNN with Chris Cuomo; January 22, 2021 – Global – 96,000,000/2,000,000; USA – 24,500,000/409,000 Some confusion about whether 100 million doses in 100 days or 100 millionb people in 100 days. Finally straightened it out and it is “doses” not “people”. Press are starting in aready in first criticizing that the goal is too lofty and now they are saying that the bar is tyoo low since we are already getting 800K per day. You just cannot win. PRESS: CNN New Day with John Berman; Black News Channel with former Mayor Sharon Pratt; WTOP Radio with Mike Murillo; University of Montana Student newspaper (Jacob Owens); NPR – “All Things Considered” – Mary Louise Kelly; NBC LX TV with Tabitha Lipkin and Ashley Holt; Conference of Mayors Panel – with Vivek Murthy – picked up by networks, cable, and C-SPAN; MSNBC – Rachel Maddow; January 23, 2020 – Global – 97,000,000/2,000,000; USA – 24,700,000/413,000 PRESS: Vaccine Town Hall with Ebro Darden & Kizzy Corbett; MSNBC with Alex Witt; Interview with Donald McNeil for the New York Times on my experience with the Trump administration; MSNBC “Politics Nation” with Rev. Al Sharpton; Stat: The 10 Biden officials to watch on the Covid-19 response By RACHEL COHRS @rachelcohrs JANUARY 21, 2021 January 24, 2021(Sunday) – Global – 97,500,000/2,100,000; USA – 25,000,000/416,000 Deb Birx had a 45 minute taped interview with Margaret Brennan right after me. It was moving in some respects, but a fair bit of revisionist history. PRESS: CBS “Face the Nation” with Margaret Brennan; CBS Sunday with ted Koppel; Donald McNeil interview in the NY Times: NYT: Fauci on What Working for Trump Was Really Like January 25, 2021 – Global – 99,000,000/2,100,000; USA – 25,000,000/418,000 • Did really good WORLD ECONOMIC FORUM Panel chaired by John Mickethwait (Bloomberg) with panelists: Prime Minister of Greece Kyriakos Mitsotakis; Nancy Brown (CEO of American Heart Association) and Frans van Houten (CEO of Royal Philips) • The vaccine is now being referred to as the “Fauci Ouchie” • Many interviews today focusing in part on the fact that Deb (on Face the Nation) and I (in the interview with Donald McNeill) opened up about the difficulties in dealing with Trump Administration. A lot of discussion about the RSA and UK variants and the potential effect on mAbs and importantly vaccines. Thus far, even though the mutants diminish somewhat the efficacy of the vaccines, the antibody response of the vaccine is still within the cushion of efficacy. Recent data indicate that the UK strain is also increased in virulence as well as transmissibility. On an interview with Erin Burnett (CNN) I went PRESS: Good Morning America (ABC) with George Stephanopoulos; Today Show with Savannah Guthrie; CBS This Morning with Tony Mason; Latino USA Radio with Maria Hinojosa (NYC); Fireside chat with Leroy Hood on receiving the 2021 Precision Medicine World Conference Luminary Award; WBUR Boston NPR Radio; WGN Radio Chicago – Bob Sirott Show; ABC TV News Live Lindsey Davis; Spectrum News TV with Alex Cohen; CNN with Erin Burnett; January 26, 2020 - Global – 99,000,000/2,100,000; USA – 25,200,000/420,000 VP Harris visited NIH for her booster shot with Husband Greg Emhoff. She and I did a PSA together. Had moving conversation with Moncef Slaoui who felt that the Biden people were discrediting and bad-mouthing OWS that Moncef led. In fact, Moncef did a fabulous job in getting 2 vaccines (Moderna and Pfizer) approved (EUA) that are highly efficacious with other candidates (Janssen, AZ, Novavax) not far behind. He feels badly for the OWS team and for himself. I told him that he has done a fabulous and historic job in what he accomplished. I told him that to me and many others, he is a hero. He was very touched by the conversation. • Got on my usual Tuesday evening Zoom call with health officials throughout the country (Hosted by David Barr) and asked question of what the problem was with doses of vaccine. Was it that we had doses but could not logistically get them into the arms of people OR was it that the demand far outstripped the supply. Overwhelmingly they said that there was not enough supply. Group was: Sharon Balter (LA), Jeff Duchin (Seattle), Jennifer Avegno (NOLA), Allison Arwady (Chicago), La Quandra Nesbitt (DC), Marci Layton (NYC) • Spoke with basketball mega-star Karl-Anthony Town. Terrific young man. He has COVID-19. His mother died of COVID-19. He is Columbian and was brought to my attention by Congressman Espaillat from NYC who is Columbian. PRESS: FOX America’s Newsroom with Dana Perino and Bill Hemmer; NBC TV Special with Richard Engel; January 27, 2020 - Global USA Really good relations developing with the WH Comms team led by Jen Psaki and particularly Courtney Rowe. Dramatic difference from Trump WH Comms Did “Fireside Chat” with NEJM – Eric Rubin and Lindsey Baden • 315 cases of the B.1.1.7 lineage (UK) in 28 states; RSA lineage B.1.351 is worrisome as it is evading mAbs and diminishing neutralizing caoacity of Abs from vaccines. Very important historical review in USA Today about the development of the Moderna vaccine: USA Today: Luck, foresight and science: How an unheralded team developed a COVID-19 vaccine in record time https://bit.ly/36i7ffM PRESS: White House Press Conference with Walensky, Fauci, Slavitt, and Zients; The Hill TV with Steve Clemons; Fox America Reports TV with John Roberts and Sandra Smith; PBS South Florida Town Hall; CNN Town Hall with Sanjay Gupta and Anderson Cooper – on with Rochelle Walensky; Daily Beast: Dr. Fauci Shoots Down Fox News Host Bill Hemmer’s Trump Questions ‘READY TO MOVE ON’ “It just seems like there’s this aggressiveness toward the Trump administration,” Fox News anchor Bill Hemmer pressed. Dr. Anthony Fauci wasn’t having it. Article in The Atlantic by Peter Nicholas – will clearly cause a stir: How Anthony Fauci Got Through the ‘Bullshit’ The new White House chief medical adviser reflects on the last year working for the Trump administration. Peter Nicholas Fox News pundit Steve Hilton pushed a FOX News: ridiculous conspiracy theory that Dr. Fauci is behind the coronavirus January 28, 2020 – Global – 100,200,000/2,200,000; USA – 25,500,000/428,000 Tedros called me up and aske me to help him connect with the Biden people, i.e. Sec Becerra, Jeff Zients, the VP, etc. Stewart Simonson willing to help me since I am ultra busy. Had confidential conversation with the Janssen people – Paul Stoffels et al about the Ad26 vaccine data. Not that great. 77% VE in USA and ~50% in RSA. Will get more details later. Data better against severe disease but this will be a messaging problem. Novavax and Janssen came out with their embargoed (until tomorrow) results of their trials: Novavax phase 3 in UK – 90% VE; Phase 2b in RSA – 50% VE. Janssen phase 3 in USA/RSA/Brazil - 72% VE at 28 days (a 1 dose vaccine); 85% VE against severe disease; 57% VE in mod/severe disease in RSA at 28 days and 88% VE with severe disease in RSA Much press activity and emphasis on the fact that antigenic variation has clinical consequences. Also, with both vaccines, good news for the global supply PRESS: Good Morning America (ABC) with George Stephanopoulos; NPR Morning Edition with Sarah McCammon; January 29, 2020 – Global USA • Fireside Chat with NYC Health Commissioner David Chokshi Met with Jeff Zients and Team to discuss what to do with 2nd dose of vaccine, i.e. hold it back completely, hold it back 90%?? PRESS: Did press conference at NIH for the release of the Janssen data; Did White House press conference for COVID-19 in general; PBS NewsHour with Judy Woodruff; NBC Nightly News with Lester Holt; WUSA TV with Gabe Cohen; New York Press Club Fireside Chat with Steve Scott; Filming with Sanjay Gupta for CNN Documentary; January 30, 2021 – Global – 101,400,000/2,200,000; USA – 25,900,000/435,2000 Daily cases continue to come down, but growing concern about the arrival of mutants: B.1.1.7 (UK) in 30 states and 434 people infected; B1.351 (South Africa) with 2 cases in South Carolina; P.1 (Brazil with 1 case in Minnesota RSA strain identified today in person in Maryland Went on a filmed walk with Sanjay Gupta and Chris on the C & O Canal as part of the Documentary that he is doing (See yesterday). Had zoom call with Rob Manfred (Commissioner of MLB) and Dan Halem (Deputy Commissioner). They want to delay opening Spring training from February 17 to March17 and have a comparable delay in opening day. They want to do this since they feel (rightly so) that the decreases in cases will be even more pronounced with an additional month and they will be able to get more of the umpires and players vaccinated with the delay. Of note, Tom Frieden spoke with the MLB Players Association and the players want to start earlier since it affects their salaries. Now the Players want to speak with me. January 31, 2021 (Sunday) – Global – 102,100,000/2,200,000; USA – 25,900,000/438,000 Zoom calls today discussing: a) vaccinations for the Federal workforce b) Vivek just wanting to discuss masks, variants, schools, etc. – touching base. February 1, 2021 – Global – 102,600,000/2,200,000; USA -26,000,000/440,000 Had usual MWF Press conference by Zoom Had discussion with the team (+John Mascola) about how best to utilize the J & J product (Ad26). There will be a messaging issue about 72% versus 94-95%. We cannot designate it for any specific group for that reason and so we decided to just out it in the mix with the other vaccines and have people make their choice based mostly on 1 dose vs 2 doses. Got call tonight from Mayor Bill Di Blasio very concerned that the supply of vaccine for NYC is no where near meeting demand. He is begging me to check with WH and see if anything can be done – DPA or some other mechanism. I will speak with David Kessler about this. PRESS: White House Press conference with Nunez-Smith, Walensky and Slavitt; mGreta van Sustern – VOA; KMEX 34 TV – Los Angeles – Hispanic; CNN Situation Room with Wolf Blitzer February 2, 2021 – Global – 103,000/2,200,000; USA -26,200,000/442,000 Daily cases going down but deaths still lagging at around 3000 per day Mutants continue to evolve with the 484K mutation characteristics of the B.1.351 lineage in RSA now being seen in the UK with the B.1.1.7 lineage. Goes along with what I have been saying that viruses will mutate if you give them free rein to replicate. Viruses that do not replicate will not mutate. Bill DiBlasio called me back and I explained to him that I had spoken to David Kessler about the Supply-demand issue with the vaccines and that there really was no solution. It is too late to invoke the DPA to have other factories make mRNA vaccine. By the time they gear up, there will be enough vaccine from multiple companies to vaccinate the entire country. Met with POTUS and VP in the Oval office with Jeff Zients, Natalie Quillian, Andy Slavitt and Walensky and Nunez-Smith on video screen. Discussed the status of the outbreak (Walensky) and vaccines, particularly recent data on J & J and implications for variants (Fauci) PRESS: Washington Post Live – Online interview with David Ignatius; Australia “60 Minutes” TV; MSNBC “All In” with Chris Hayes; CNN with Don Lemon Washington Post – 02/02/2021: Poor handling of virus cost Trump his reelection, campaign autopsy finds “Voters in the states overwhelmingly supported a mask mandate — 75 percent — and Anthony S. Fauci, the country’s top infectious-disease specialist, secured an approval rating almost as high. Trump did not support a mask mandate — sometimes mocking the wearing of masks — and regularly criticized Fauci, threatening to fire him at times. Advisers repeatedly encouraged Trump to wear a mask, stop attacking Fauci and signal to the public that he was taking the coronavirus more seriously” How Anthony Fauci beat Donald Trump in February 3, 2021 - Global USA Biden Comms team putting me out there with the press continually. They are giving me totally open clearance for everything that I get asked to do. Completely different from the ridiculous restrictions of the Trump Comms team • Daily cases continuing to come own. Much emphasis on the impact of the variants. PRESS: ABC Good Morning America with George Stephanopoulos; NBVC Today Show with Savannah Guthrie; February 4, 2021 – Global – 104,000,000/2,3200,000; USA – 26,400,000/449,000 Discussions last night and prior evenings regarding the use of the excess J & J vaccine of clinical trial grade. Move to donate this to RSA to vaccinate their HCWs. RSA has been pleading with the USA to help them get vaccines since they are being ravaged by the B.1.351 variant. Phone call last night with David Kessler, Beth Cameron/Hilary Marston (NSC), me and Cliff Lane to figure out a mechanism to get this to them since it is only clinical trial grade. And we want to avoid the optics that we are either a) giving away vaccine meant for USA to RSA or b) we are “experimenting” on black Africans. • Gave one of several plenary addresses at a Brookings -Tsinghua University Roundtable of US-China Collaboration on COVID-19. Chinese Speakers included Zhong Nanshan, Wang Chen, Gao Fu Had nice conversation with the MLB Players Association with Tony Clark (Exec Director), Bruce Meyer (Senior Director, Collective Bargaining and Legal), Ian Penny (General Counsel), Kevin Slowey (Director Player Services), Matthew Nessbaum (Deputy General Counsel), Robert Lenaghan (Assistant General Counsel) and Max Scherzer (member, Exec. Comm.). They asked great questions about vaccines. I emphasized that I did not want to get in the middle of a dispute between MLB and players regarding when to start the season. They understood perfectly. I had some nice back and forth with Max Scherzer. PRESS: BBC Radio with Tim Harford; NBC TV Boston – LaToya Edwards; MSNBC with Ari Melber; NBC TV “off the record” discussion with the entire NBC TV team; CNN with Chris Cuomo. February 5, 2021 – Global USA - Had terrific conversation today with Bob Cousy. Sen. Joe Manchin (D-WV) had called me a couple of weeks ago saying that Bob Cousy would love to connect with me by phone, Joe is a good friend of Cousy’s. I called Bob’s cell phone and we spent 20 minutes chatting about all kinds of things. He has a great sense of humor. He is disturbed by the devisiveness in our society (similar to my concern). He spoke about his being 92 years old and that he body in “falling apart” despite the fact that he has “all my smarts”. He is a rally charming guy. We developed a great rapport on the phone. Note that he came to my lecture at Holy Cross a few years ago and we had dinner together. PRESS: Had usual White House Virtual Press Conference with Andy Slavitt, Rochelle, me and Tim ….; FOX TV with Neil Cavuto; February 6, 2021- Global -105,000,000/2,300,000; USA – 26,700,000/458,000 Had Zoom call with David Kessler and the BARDA people trying to decide whether to invest considerable money in guaranteed purchase of the Lilly mAb combination that will soon go for an EUA. Their data look fairly good for treatment of early disease to prevent hospitalization and PEP • Got call from Mike Osterholm trying to convince me to go with his concern/recommendation that we go with1st doses to as many people as possible given the fact that B.1.1.7 (UK) may become dominant in the USA and increase cases/hospitalization. This is a difficult problem sine we only have data for prime/boost with mRNA vaccines. February 7, 2021 (Sunday) – Global – 105,400,000/2,300,000; USA – 26,800,000/461,000 Superbowl Sunday! Tom Brady beast Patrick Mahomes PRESS: Meet the Press (NBC) with Chuck Todd; February 8, 2021 – Global – 106,000,000/2,300,000; USA – 27,000,000/462,000 Important point is that the vaccines are protecting against severe disease (hospitalization and death): First day since Nov. 2 that daily cases were less than 100,000: Kat McKinnon played me again on Saturday Night Live: https://bit.ly/36SyePm Did fireside chat with Prince Georges County - County Executive Angela Alsobrooks and Drs. Carter and Wright to discuss vaccine in the African-American community PRESS: AP Interview with Mike Stobbe; FOX TV News “Special Report” with Bret Baier February 9, 2021 – Global – 106,100,000/2,300,000; USA – 27,000,000/464,000 Eric Lander (OSTP) visited the VRC today and I we briefed him on our activities, particularly the development of the mRNA vaccine and Barney’s development of the stabilized pre-fusion Spike protein. Of note, Martin Fletcher of the Daily Telegraph did a profile of me and told me that the London Times had asked him to gather information for them for an obituary that the Times wanted to put “in the can” just in case I passed away suddenly. They wanted to be the first to have an obituary PRESS: Fireside Chat with the COVID Collaborative – Gov. Dirk Kempthorne, Gov. Deval Patrick, and Gary Edson; Interview with Martin Fletcher of the Daily Telegraph for a profile of me; February 10, 2021 – Global – 106,600,000/2,300,000; USA – 27,000,000/467,000 Cases continue to fall considerably. We are now at less than 100,000 cases per day, when we were up to 400,000 at one time. • Had zoom with Dr. Hans Kluge WHO Regional Director for Europe • Did Fireside Chat with David Rubenstein as part of the Duke Global Health Institute Victor Dzau Lecture • Pleasant thing – I had mentioned on a radio or TV show that what I missed most about NYC was the Nathan’s hot dogs. Today sitting on my home from steps were two packages of Nathan’s hot dogs – a gift with a nice note from Tim Shriver saying that he “could not resist the hot dog invitation”. Had a wonderful experience this evening. I received (virtually) the Award of Courage from AmFAR. It was presented to me virtually by Julia Roberts from her breakfast room in her home in Northern California. She was so charming. When my image came up on the screen she gasped and said that every time she sees me her throat gets dry and she gets nervous and excused herself to go into the kitchen and get a glass of water. When she came back and introduced me it was the most wonderful introduction. She introduced me to her son while we waited to check the filming and we chatted a bit. She is so charming, natural, fun and amazingly beautiful. PRESS: Did routine MWF White House Press conference. I spoke about making sure that people with immune deficiencies or on immunosuppressive drugs get vaccinated since they are very vulnerable; Interview with Rima Krist of the Navajo Times February 11, 2021 – Global – 107,000,000/2,300,000; USA – 27,100,000/470,100 Number of daily cases continue to diminish. CDC starting to do practical things that I have actually been pushing for some time. For example: Wearing 2 masks could be better than just one. They did a dummy study and showed that a cloth mask over a surgical mask actually gives a more complete fit and keeps out aerosols. Another example is that people who are vaccinated do not need to go into quarantine after exposure to a documented COVID-19 case. POTUS Biden visit to NIH. Biden visited the NIAID VRC today at 3:30 PM on a sleety and snowy day. It was a great visit. I presented to him the history of the VRC and the importance of the work that Barney Graham has done with the stabilized spike protein. We brought Biden into the room where the experiments were done and Barney and Kizzy Corbet presented to him. He was accompanied by Jeff Zients. We then went to Natcher Auditorium where he addressed (virtually) the NIH community with a great speech in which he called out Francis and I multiple times. PRESS: Today Show (NBC) with Savannah Guthrie – discussed new mask recommendations from CDC and the B.1.1.7 variant; BBC Radio; “What a Day” podcast; CNN Sports TV with Charles Barkley and Ernie Johnson; Univision TV interview; Axios TV for HBO – update with Margaret Talev Nice article in Vogue: For Dr. Anthony Fauci and Dr. Christine Grady, Love Conquers All By Michelle Ruiz Power Players CNBC: Bill Gates and Dr. Fauci talk regularly — here’s what they’re discussing now Published Thu, 12:25 PM ESTUpdated Thu, 12:26 PM EST Cory Stieg@corystieg February 12, 2021 – Global – 107,000,000/2,400,000; USA – 27,200,000/474,000 David Kessler and I had discussion with Sen. Burr and Murray about viral variants. They wanted to be briefed on the threat and what we are doing about it. Did a briefing of the Foreign Press with Andy Slavitt Briefed the Deputies and Cabinet Secretaries led by Jeff Z. PRESS: Good Morning America (ABC) with George Stephanopoulos; Univision TV with Jorge Ramos; ABC/FOX Montana TV; Podcast with Al Franken; February 13, 2021 – Global – 107,800,000/2,400,000; USA – 27,300,000/479,200 • Trump acquitted by the spineless GOP Senators. However, 7 GOP Senators did vote for conviction. Sorry day for our country. Trump still has them in his grip. February 14, 2021 – Global – 108,200,000/2,400,000; USA – 27,400,000/482,500 Cases continue to come down. People like Mike Osterholm are saying that we will inevitably have yet again another surge due to B.1.1.7 that will become dominant. I do not necessarily believe that this will be the case. I believe that if we double down on public health measures and continue to push vaccinations, we do not necessarily have to experience a surge. Having said that, WE MUST BE PREPARED FOR A SURGE. PRESS: ABC “The Week” with George Stephanopoulos February 15, 2021 – Global – 108,600,000/2,400,000; USA – 27,500,000/484.000 Down to 68,000 cases yesterday! Did Zoom call with Winnie Byanyima (Exec Dir. Of UNAIDS) together with Regan Hofmann. Winnie was very grateful for my leadership in COBID-19 and HIV/AIDS. We discussed the importance of having a global effort (hopefully led by USA) to get the world vaccinated against COVID-19. Winnie was excited about the fact that I mentioned the loosening of patents in a recent interview to allow wider availability of COVID-19 vaccines. I promised that I will continue to push the “international and global” agenda. I mentioned that we would need to get things under better control in the USA before we would be able to generate interest in global issues. PRESS: Telemundo HOY DIA TV; NBC Local TV Doreen Genzler; NPR (Daniel Estrin): The Coronavirus Crisis Fauci Awarded $1 Million Israeli Prize For 'Speaking Truth To Power' Amid Pandemic February 16, 2021 – Global – 108,800,000/2,400,000; USA – 27,500,000/485,100 Cases continue to come down globally: Media trying to show discrepancies in the Biden team response. CDC and Walensky under criticism for their recent guidelines for opening schools since they are really quite confusing. They say open the schools but the guidelines show that 85-90% of the country is in the “red” zone and therefore, should hold off on opening. I believe that this is typical CDC confusion and lack of clear crisp guidelines no matter who is CDC Director. Also, the are pitting (a little) what I am saying against what VP Harris is saying. VP saying that we have to “start from scratch” in the vaccine roll out and I have been saying that some things were done well such as the mechanism for shipping vaccines. I reconcile this by saying that the mechanisms for getting doses into people’s arms were in bad shape when the Biden team came in. The press are accepting this. Briefed (together with Francis Collins, Rochelle, and Janet Woodcock) the House and Senate Caucuses on COVID-19 variants PRESS: CNN with Jim Sciutto; LA Times TV; NPR – “Science Friday” with Ira Flatow; New York Post: Everything you need to know about Fauci-ing, the new COVID dating trend By Emily Jacobs February 17, 2021 – Global – 109,200,000/2,400,000; USA – 27,600,000/486,400 Cases continue to plummet: Columbus Citizens Foundation's Dr. Anthony S. Fauci Scholarship - Created For Graduate Students In Medical And Public Health Fields - Now Accepting Applicants • Did Fireside Chat with AME Reid Temple Church (Maryland) – Pastor Mark Whitlock • Did podcast “Pod Save America” with Jon Favreau • Did podcast with James Hildreth from Meharry Medical College PRESS: CBS This Morning with Gayle King and Tony Dokoupil; Online TV interview with Clive Cookson (Editor, Financial Times) for the UK Science Museum event; White House Press Conference on the usual MWF schedule; CNN “360” with Anderson Cooper. February 18, 2021- Global – 109,600,000/2,400,000; USA – 27,700,000/489,100 Big Ice-storm in Washington DC and major ice storms and snow over southwest (Texas) with several deaths. Currently heavy snow in NYC and Boston Cases continue to drop Briefed President Biden today in Oval (Virtually). I briefed him on pediatric vaccine trials and mentioned that we likely will have high school children (13-17 yo) vaccinated by mid-Fall, but it would take until Q1 of 2022 to get the trials done and approval for elementary school children (6 to 12 yo). He asked good questions but he rambled a bit, seemingly repeating things that he had said a few minutes previously. • Did really fun “Fireside Chat” with Karl-Anthony Towns (All-Star NBA Player – Rookie of the Year in 2015-2016) and “Dominicans on the Hill”. He had COVID-19 and` his mother died of COVID-19. We gave good messages to the Dominican community • Spoke with the PEPVAR group about USA providing $4-5 billion to build plants to produce Moderna mRNA for the world – Peter Staley, James Krellenstein, David Barr, Christian Urrutia, Wafaa El Sadr. I will bring this up to Jeff Zients. PRESS: MSNBC with Andrea Mitchell; Council on Foreign Relations podcast – “Why it Matters”; Interview with Char Koosta News (discussed tribal Vaccine hesitancy with Sam Sandoval); Interview with Times of Israel on my Dan David Prize; Interview with Alice Park of Time Magazine on 1st 100 days of Biden Administration; Did Buzzfeed interview with Dan Vergano on the Fateful March 11, 2020 when we shut down Europe. February 19, 2021 – Global USA Online preprint paper cam out from Israel saying that a single dose of Pfizer mRNA protected well (85% at 15-28 days against symptomatic disease and 72% against symptomatic and asymptomatic disease). 9000 individual study of young and healthy people. We do not know the durability of this protection. I made point at the press conference (see below) that we will stick with the 2 dose since we know from our studies that the 2nd dose increases the response 10fold over the 1st dose. This height of response gives a cushion against the existing variants and also if you have a less-than-optimal response (albeit a good response) to the 1st dose, you may actually “select” for more variants. • Call from Jeff Sachs about the International Monetary Fund (Special Drawing Rights – SDR) and the possibility of a $40-$50 billion dollar program to vaccinate the entire world. He wants me to have a special role. Moe later. • Gave Harvey lecture virtually at Georgetown • Met with Francis C, Carl D, John Martin, and Larry Tabak about the COVID targeted drug development program that I am trying to set up with the $743 million that we put into our total NIH budget request. It will be based in NIAID with Carl as the lead. As usual Francis wants governance to be somewhat under his control. All good. We will get it done. PRESS: Interview with Erin Banco – The Daily Beast; White House Press Conference; ESPN Baseball TV with Buster Olney; interview with Ben Samuels of Haaretz Israel Newspaper (he tried to get me involved with commenting on the policy of Israel and I refused); MSNBC with Joy Reid; February 20, 2021 – Global -110,400,000/2,400,000; USA – 27,800,000/494,000 PRESS: February 21, 2021 – Global – 110,700,000/2,500,000; USA – 27,900,000/499,000 Matt Pottinger’s interview with Margaret Brennan on Face the Nation. Good summary of history of the early months: https://cbsn.ws/3pGH9tR Mike Osterholm still predicting an “inevitable” massive surge in the Spring. He also is insisting that we can study the 1 dose strategy in time for meaningful results. PRESS: Sunday shows: NBC - Meet the Press with Chuck Todd; FOX Sunday with Chris Wallace; CNN State of the Union with Dana Bash. February 22, 2021 – Global – 111,100,000/2,500,000; USA – 27,900,000/500,000 Reached 500,000 deaths in the USA today!! However, numbers of new cases continue to come down. Will be race between the new variants and our two tools of defense: 1) vaccine; 2) public health measures. Luckily the mRNA vaccines and J & J are good against the B.117 (UK). Even though they are less effective against the B1.531 (RSA) isolate they still likely will protect against hospitalization and death – the J & J definitely does (tested in RSA) and we can extrapolate that the mRNA (not yet tested in RSA) also does. PRESS: The Telegraph: https://www.telegraph.co.uk/politics/0/dranthony-fauci-had-publicly-disagreetrump-allowed-terrible/ Anthony Fauci exclusive interview: 'When I publicly disagreed with Trump he let terrible things happen' Good Morning America (ABC) with George Stephanopoulos; CBS This Morning with Gayle King and Anthony Mason; PBS “GZERO WORLD” with Ian Bremmer; White House Press Briefing – I outlines therapeutics and the new FDA updated guidelines to companies for handling variants; Fireside Chat with David Rubenstein upon my receiving the 2021 Great Americans Medal from the Smithsonian’s National Museum of American History; Reuters online TV interview with Julie Steenhuysen; i24 TV News (Israel); Fireside chat with Leon Panetta at his Panetta Institute for Public Policy. February 23, 2021 – Global -111,400,000/2,500,000; USA – 28,000,000/500,000 Had great call with Barbra Streisand. She called my cell at 6:05 PM. She has recently had zoster with lesion on hip/buttock. She has post-zoster neuralgia down her leg, but the primary lesion had healed. She wanted to know if it was OK to get the mRNA vaccine. I told her yes. We then stared discussing life in general. I told her that I work listening to her songs on ALEXA. She really did not know what ALEXA was. I accidentally butt called her later in the evening and she said that she was going to call me anyway since she wanted to know if there was any difference between the Moderna and the Pfizer product. I told her none. I then explained to her more about ALEXA. I brought the phone over to ALEXA and asked to play “Songs by Barbra Streisand”. When the song came on loud and clear, she started laughing and absolutely loved it! PRESS: Yahoo News Interview February 24, 2021 – Global – 111,800,000/2,500,000; USA – 28,100,000/501,200 The PBS team is here today filming their documentary. Received the 2021 Larry Foster Award for Integrity in Public Communication from the Arthur W. Page Center (Donald P. Bellisario College of Communications of Pennsylvania State University PRESS: February 25, 2021 – Global – 112,200,000/2,500,000 USA – 28,000,000/503,600 Cases continue to come down, but yesterday was 1st day that cases actually started to back up a little. Could be artifact. Variants gaining much attention. The B1.427/429 in California is spreading in CA and seems to be somewhat more transmissible. The new B.1. 526 in NYC is also troublesome and spreading. Issue with J & J. VRBPAC will meet on Feb. 26 (tomorrow). Big Day at the White House - Met with POTUS and VPOTUS in the Oval office for our weekly briefing on COVID. In Oval with us was Jeff Z, Natalie Q; on screen weas Rochelle and Marcella. I presented the options for the upcoming ruling on J & J for EUA. Data on >60 WITH comorbidities doers not look good. Overall USA efficacy 72%. I also described the Moderna efforts to do with NIAID Phase 1 trials with a boost to previously vaccinated and prime/boost for previously not vaccinated people using the B.1.531 (South African variant). Then went with the POTUS and VPOTUS to South Court auditorium to watch NIH OMS nurse Elizabeth Galloway administer mRNA (Moderna) to 4 volunteers to celebrate before a packed press the 50 millionth vaccine within 37 days of Biden Presidency Then went to do PSAs with the White House digital Comms team. They all wanted selfies with me. Had 5:00PM call with Janet Woodcock, Francis Collins, John Mascola, Cliff lane, Peter Marks, and we decided that it would be best to recommend and EUA for people younger that 60 years old because the >60 years with co-morbidities had only a 42% efficacy. Had 6:30 PM talk led by Bechara Choucar and including me, Rochelle and Marcella at the request of Jeff Z to discuss what two vaccinated people can do together. We were getting criticism that we were not using common sense to tell people that they can now relax a bit and enjoy each other. Example I give in being able to hug Jenny now that we are both vaccinated. Th right wing crazies at FOX have been criticizing me for not recommending loosening up. I have true to not get ahead of the CDC sine I feel stringy that two vaccinated people can act together like there is no outbreak. However, in society, this would be different. My point is that the risk is very small and each person should evaluate the level of risk they are willing to take to start getting back to normal. I will give my professional judgment while we are waiting for the CDC to come out with some guidance. I will be on all the Sunday Shows this weekend and this is what I will say. Rochelle agrees and says that the CDC will be coming out with some professional judgment guidelines soon. E-mail from Leon Panetta: From: Panetta Institute <info@panettainstitute.org> Sent: Wednesday, February 24, 2021 8:15 PM To: Conrad, Patricia (NIH/NIAID) [E] <conradpa@niaid.nih.gov> Subject: From Leon E. Panetta to Anthony Fauci Dr. Anthony Fauci Director National Institute of Allergy and Infectious Diseases c/o Patricia Conrad conradpa@niaid.nih.gov Dear Tony: Sylvia and I want to express our deepest thanks for your generous participation in our Lecture Series. We broke a record with over 1,400 attendees and received a number of compliments on your performance. One of our friends – a former Trump supporter – said “I’ve changed my mind – Fauci is a good guy!” Of course, he too is Italian. We look forward to one day taking you and your wife to a great Italian restaurant whether in Washington or here in Monterey. Either way, we are deeply grateful for your kindness and service to our nation. Regards, Leon LEP:sb PRESS: Today Show (NBC) with Savannah Guthrie; Newsweek interview with Jack Dutton (British); CBSN Interactive with Tanya Rivero; CNN with Chris Cuomo From Axios: 21 mins ago - Health "This is a race": Fauci urges Americans to take whatever COVID vaccine is available Sarah Mucha Good summary of the year: A year after Trump said coronavirus was ‘under control,’ a look back at the first news stories President Donald Trump at the Centers for Disease Control and Prevention in Atlanta on March 6, 2020. (Alex Brandon/AP) By Philip Bump at 9:36 p.m. UTC February 26, 2021 – Global – 112,600,000/2,500,000; USA – 28,200,000/506,800 Cases continue to fall however we're paying considerable attention to the possibility of surges associated with the variants. Of note, Pfizer is planning to do a boost at about six months in order to increase the level of neutralizing antibodies that could cover indirectly the variants. OK put together a zoom meeting for me to talk to members of the RED organization to discuss the global aspects of the COVID-19 pandemic. They were people from all over the world whom I did not recognize but several of them were apparently famous artists and entertainers. One of them was Larry Gagosian who is a very famous art dealer. The tone of the discussion and the questions was the importance of a global response to a global pandemic. In this regard I stressed, and they totally resonated with me, the importance of making vaccine available to the entire world since an outbreak in any part of the world is threatening to every part of the world. There was some nice warm interchange between Bono and I at the beginning of the discussion and throughout. He mentioned that his son has started a rock band and since his son has asthma they called the band the inhalers. Unfortunate and sad situation – Received a call from Tony DiNovi, Chair of the Board of Trustees of Regis High School, that Father Dan LaHart has been removed indefinitely from the Presidency of Regis High School. Apparently, he was involved in sexual impropriety with adult male members of the Regis community. There is also an issue of alcohol abuse. He is currently secluded in a treatment center. Tony called me because the story will likely be in the New York Times on Monday and the press might be calling me since it is widely known that I am strongly connected with Regis PRESS: We had the usual White House press conference on the Monday , Wednesday, Friday schedule; CBS 60 Minutes PLUS (taped); MSNBC Town Hall with Joy Reid. February 27, 2021 – Global – 113,200,000/2,500,000; USA – 28,300,000/509,000 Had good conversation with Ashish Jha. He is a good guy and he wants to understand much better why I am insisting on a single dose of the vaccine rather than adhering to what others are suggesting about giving all one doses and then worrying about the second dose three months later in order to protect as many vulnerable people as one can. I explained to him our strategy that the major concern is the evolution of mutations (variants) that would not be covered by a less than optimal level of neutralizing antibody. We know that when we look at the in vitro data the variants diminish the efficacy of the vaccine-induced antibodies; however, the high levels of antibodies induced by the 2nd dose give some degree of protection (cushion) even against the mutants. Therefore. we are concerned that if we only give first doses and we wait three months or more to give the second dose that variants may dominate and infect the suboptimally protected people. In addition, a suboptimum level of response could actually select for mutants. In addition, there was no reason why we cannot dramatically increase the administration of doses together with the markedly increased availability of vaccine such that we can have our cake and eat it, namely, we can give a lot more first doses at the same time as we keep up with the second doses. We really need the CDC or another organization to model that. I will explain this all to Ron Klain on Sunday. I had an important conversation today led by Janet Woodcock and Peter Marks of the FDA about the J & J EUA. Also on the call were Francis Collins, Cliff Lane, and Rochelle Walensky.The subject matter was that their advisory committee (VRBAP) for consideration for an EUA for the J & J product (Ad26). The committee unanimously and strongly recommended an unqualified EUA even though the data for elderly individuals older than 60 years old with comorbidities was 42%. However, there were not enough data points to be able to make a definitive statement that there is a significant diminution of efficacy in that subgroup. Janet and Peter are very concerned since they wanted the recommendation to be that the EUA would involve people younger than 60 years old. Apparently, the AC IP will go along with that recommendation. Rochelle and I in our conversation with Jeff Zients had decided that when asked by the press we would say that this is an excellent vaccine equivalent to the other two. It might become problematic if the press focuses on that group older than 60 years old with comorbidities. The fact is that the numbers are so low that you cannot say anything about the subgroup analysis. Janet and Peter will face the press tonight. We help them to get a consistent message with ours. This is critical since I will be on four of the Sunday talk shows tomorrow. Throughout the late afternoon I was on several calls with Jeff Z who kept on checking with Ron Klain regarding what the right approach would be when asked on TV about what people who had both doses of vaccine could do with each other such as having a dinner with family and a few guests all of whom were vaccinated. Ron was quite concerned that I not go too far out on a limb and say that vaccinated people can safely interact with unvaccinated people in a household setting. Ron was also concerned about the issue a vaccinated people interacting with unvaccinated children. Finally after many calls going back and forth between me and Jeff and then between Jeff and Ron and back to me again we decided to have a 3 way call among Jeff, Ron, and me. We worked it out such that I will say that I am comfortable with adults in a small gathering within the home not wearing masks as long as everyone was vaccinated. Importantly, I would stay that the CDC would be coming out with recommendations in the next couple of weeks. PRESS: On Saturday Night Live played by Kate McKinnon: Pop Culture SNL dreams up a Fauci-hosted game show where contestants vie for the vaccine Travis M. Andrews at 12:51 a.m. EST February 28, 2021 (Sunday) – Global – 113,500,000/2,500,000; USA - 28,400,000/510,800 Big topic on the Sunday shows (see below) was the EUA Issued by the FDA for the Johnson and Johnson adeno virus vaccine. Also, there is concern that I expressed about easing up on prevention modalities since the decreasing slope up infections is starting to show signs of plateauing. On Face the Nation( see below) Margaret Brennan showed a clip of me being portrayed on Saturday Night Live by Kate McKinnon. Also, the governor of South Dakota Kristi Noem said that I was almost always wrong. She claims that the most important parameter of how well you are doing is how you maintain hospital capacity. When Margaret play that clip I was kind to the governor by saying different states do different things and in different ways, whereas I might have pointed out that her state has the most deaths per capita by COVID-19 than any other state in the country. Got a call from Jeff that Anita Dunn saw me on all the shows and said that I was fabulous. Flattening of decline concerning. We shall see what happens in the coming days and weeks. Had zoom call today with Ron Klain arranged by Jeff an included me Bechara, Marcela, Rochelle, Natalie, and others. The main topic was whether we should stick with our strategy of two doses in the usual time frame or switch to one dose and extend the interval by a couple of months before giving the second dose. Ron is concerned that in November we will be criticized for having let a few million people who would have been vaccinated remain UN vaccinated because we wanted to give two doses to everyone. I was the main explainer emphasizing that the second dose gives a much higher titer of antibody that will address at least partially the inevitable evolution of variants including those from California and importantly the B.1.526. Ron did not want to tell us what to do but he wanted to make sure that we seriously considered both alternatives and were comfortable without decision to stick with two doses on the regular regiment. The ACIP recommended to CDC to implement the EUA for the J & J vaccine. Now the CDC needs to recommend the distribution and we can start distributing 4,000,000 doses almost immediately and then we will have 20 million by the end of March and a total of 100,000,000 by the end of June PRESS: Was on 4 Sunday talk shows: ABC This Week with George Stephanopoulos; CNN State of the Union with Dana Bash; CBS Face the Nation with Margaret Brennan; NBC Meet the Press with Chuck Todd. March 1, 2021 – Global – 113,800,000/2,500,000; USA – 28,400,000/512,000 • We did our weekly briefing of Principals – Cabinet members and deputies • Did a podcast with the New Jersey Council of Churches PRESS: NPR Radio 1A; Podcast with Kai Kuperschmidt (Science Magazine) on HIV versus COVID-19 vaccines; White House Press Conference (Routine 3x/week);Satellite Radio Tour for Native Americans; Podcast with the Interactive Advertising Bureau (David Cohen); March 2, 2021 – Global – 114,100,000/2,500,000; USA – 28,500,000/513,100 Still coming down, but the slope is changing: Participated in the University of Edinburgh “Futures Conversations” Chaired by Professor Peter Mathieson (Vice-Chancellor, University of Edinburgh) and involving a conversation between me and Professor Nanshan Zhong (China) and Sheila Tlou (former Minister of Health of Botswana) on the global impact of COVID-19. We spoke about global solidarity for vaccine equity. Also, spoke about the variants. Also, spoke about the approach that China took with the outbreak, i.e. complete lockdown Call from Larry Horowitz. Nancy Pelosi is angry about the fact that J & J is being equated with the mRNA vaccines since she has seen the data about the people >60 yo with co-morbidities. Also, she does not like the 72% versus 94-95% for mRNA. She is taking her annoyance out on the medical team (she has not PRESS: Podcast with Kai Kuperschmdt (follow-up from yesterday0; Seattle Gay News interview; Interview for Pritzer Forum/Chicago Council; Hispanicize PSA taping (Paola Ramos); Telemundo 52 Los Angeles; In Washington Post (see below) Fauci: U.S. must stick with two-shot strategy for Pfizer-BioNTech, Moderna vaccines Delaying a second dose to inoculate more Americans creates risks, infectious-disease expert says By Dan Diamond March 1, 2021 at 8:38 p.m. EST March 3, 2021 – Global – 114,400,000/2,500,000; USA – 28,500,000/515,300 Still plateauing: Note that Europe cases are going up. They are using the 1 dose of vaccine approach: Governors of Texas and Mississippi withdraw all public health measures such as masking and not doing indoor dining. I and Rochelle and Biden on TV saying that this is risky and illadvised. NEWS CLIPPING — NBC NEWS — CONDENSED (1 SOURCE PAGE) “PRESS: BBC Scotland Morning Radio Show; Black News Channel with Kelly Wright; Brandeis Webinar with Atul Gawande and Elizabeth Rosenthal; Town Hall with United Food and Commercial Worker Union; CNN with Erin Burnett; My prediction,…” March 4, 2021 – Global – 115,000,000/2,600,000; USA – 28,600,000/517,200 Continuing to plateau: Governors of Texas and Mississippi are pulling back on all public health guidelines such as masks (removing the mask mandate), physical distance, crowds. Press slamming them for thisand Rochelle and I are being asked about this on every media hit. Had very good discussion with Dr. Soren Brostrom, Director General of the Danish Health Authority Danish representative on the WHO Executive Board AND Lone Dencker Wisborg, Danish Ambassador to USA on Global Health matters and potential collaboration between USA and Denmark in global health security and pandemic preparedness. Also met with Congressman Espaillat regarding variant B.1.526 in his district in NYC. Had back and forth with Jeff and Rochelle regarding the guidelines that CDC is preparing on what people who are vaccinated can and cannot do. Jeff Wants to make sure that I am comfortable with the guidelines. I looked at them in the usual manner the CDC had too many qualifying statements in there that were necessary. Jeff had a problem with putting a vaccinated person in the same room with a person who is not vaccinated and not using masks. I convinced him that we should assume the very small risk and if the person who is not vaccinated is of low risk, then one does not have to wear a mask. Jeff was very sensitive in not having the White House interfere and so he went along with my suggestion that actually agreed with the CDC, except for the fact that they were not precise in their wording can I edited their document some what. The bottom line is that we would say that two vaccinated people can be indoors together in a home setting without masks or physical distancing. In the home setting, where one person is vaccinated and the other person is not, the vaccinated person has a minimal risk and attention should be paid to the risk of the unvaccinated person. If the person who was not vaccinated is of a low risk then they can do away with masks and can be together. If the person who was not vaccinated is of high risk of severe disease then the vaccinated person needs to wear a mask. I worked with Rochelle and returned the document to her.Let us see how it ultimately turns out I received the AmFAR “Award of Courage” on a virtual Gala tonight. The award presented to me (recorded) by Julia Roberts PRESS: MSNBC “Morning Joe” with Joe Scarborough, Mike Brzezinski, and Willie Geist; Interviewed with Alexis Papachelas of Greek Kathimerini Newspaper; WTOP with Mike Murillo (Online and Radio); NPR with Rob Stein; Town Hall with Blue Star Families; CNN “The Lead” with Jake Tapper; CBS Newspath with Jon LaPook; NBC with Lester Holt – doing special of last photos that people took before the Pandemic struck. I showed photo and gave interview about that 2019 Christmas Eve dinner at my sister’s home; Interview with The Atlantic with James Hamblin on COVID-19 epidemiology March 5, 2021 – Global -115,300,000/2,600,000; USA – 28,600,000/519,100 Plateau maintaining: Briefed POTUS and VPOTUS virtually. He was in Oval. I was at NIH. I explained about variants and how the “cushion” of antibodies provided by the 2nd dose of vaccine give considerable protection against severe disease PRESS: Black News Channel Morning Show (TV); Time video regarding Sesame Street; Washington Post interview regarding vaccine hesitancy (Online TV); 2 PSA with Gloria Estaban and Carolina Sandoval; White House press conference; March 6, 2021 – Global – 115,700,000/2,600,000; USA – 28,700,000/521,300 Had pre-brief with the WH comms team (Courtney Rowe, Ben Wakana, Kate Berner, Mariel Saez, Ian Sams, etc for my appearance on Face the Nation tomorrow (Sunday). 7day average is not exactly plateauing, it is just flattening a bit: GOP at the local level are trying to pass laws that suppress minority voters such as saying that you cannot give food to people who are waiting in line for hours to vote. This disproportionately affects African American voters. PRESS: MSNBC with Tiffany Cross; March 7, 2021 – Global – 116,100,000/2,600,000; USA – 28,800,000/523,000 Status of vaccines in USA from Monica Ghandi: The intensity of both my popularity and of the hate that the far right have of me increases: Fauci.pdf PRESS: CBS “Face the Nation” with Margaret Brennan March 8, 2021 – Global 116,500,000/2,600,000; USA – 28,800,000/524,000 Plateau starting to come down” Had a very nice and informative discussion with the minister of foreign affairs of Bosnia and Herzegovina, Bisera Turkovic. She is in a very difficult situation in that she was promised vaccine from CoVAX; however, they have not come through on their promise. Therefore, she is asking me as a trusted person for suggestions on how she might address the outbreak in her own country. As of February 22, 2021 there have been 128,000 cases and 5000 deaths in Bosnia and Herzegovina. I could not help her very much except to encourage her to have her people continue to wear masks and observe appropriate public health measures. I also suggested to her that she tried to make a deal with the Russians to try to get some of their vaccine. I also suggested that are possible long range solutions to try and get some of the surplus vaccine that would be left over after the USA vaccinated its entire population. She was very grateful for the discussion. Was on panel with President Clinto Chair) for a discussion of the shortage of oxygen in the LMIC. Also there were: Joy Phumapi and John Nkgengasong • Received the Tufts University Presidential Medal and did a Zoom Q and A with the Dean of the Tisch College of Civic Life at Tufts PRESS: Interview with Sarah Owermohle for Politico; White House Press Conference; Axios interview about March 11 – with Naomi Shavin; Fireside Chat with National league of Cities; Fireside Chat with Tufts University Dean of Tisch Colege on the occasion of receiving the Presidential Medal; CBS New Radio, Los Angeles interviewed together with L.A. Mayor Eric Garcetti March 9, 2021 Global – 116,900,000/2,600,000; USA – 28,900,000/525,000 Oops! See below. Likely a fluke: • Had a very nice virtual ceremony inducting me as a Honorary Fellow into the Royal College of Physicians of Ireland by its President Dr. Mary Horgan. Bill Powderly (Washington University of St. Louis) connected us. Mary had taken an infectious Diseases fellowship at Wash U. • Did Fireside Chat with Paul Kelly (Chief medical Officer of Australia) on the differences between COVID-19 in USA and Australia. Sponsored by CSIS (Steve Morrison and Katherine Bliss) PRESS: NPR “All Things Considered” with Mary Louise Kelly (done together with Francis Collins); VICE TV Documentary Taping; Gray TV Special with Greta Van Susteren; Did podcast with Tom Inglesby from Hopkins; March 10, 2021 – Global – 117,300-,000/2,600,000; USA – 29,000,000/526,200 Had a very moving tribute to me upon the receipt of the Yale University School of Management “Legend in Leadership” Award from the Chief Executive Leadership Institute. Moving comments by Albert Bourla (Pfizer), Alex Gorsky (J & J). PRESS: CNN “New Day” with John Berman; Interview with Carolyn Johnson of the Washington Post; Instagram with Eugenio Derbez (Mexican-American entertainer) Historical comparison of the vaccine efforts of Trump versus Biden in NY Times article by Sharon La Franiere: Biden Got the Vaccine Rollout Humming, With Trump’s Help Trump administration officials grumble that they laid the groundwork for surging vaccinations, but some hard work in the trenches has helped pick up the pace of production. See link below: https://www.nytimes.com/2021/03/10/us/politics/biden-coronavirus-vaccine.html March 11, 2021 – Global -117,800/2,600,000; USA – 29,100,000/527,700 Had Zoom with Jeff and the team to go over the POTUS speech for tonight to commemorate the 1 year anniversary from the time (March 11, 2020) when the WHO declared this a pandemic of global health concern and we shut down travel from Europe. This was a big day for me 1 year ago – (go back to notes of March 11, 2020). Also, I have been pushing with Jeff and Rochelle to have the CDC be a bit less “risk averse” in their recommendations of what a person can do once they are fully vaccinated. The CDC really needs to step up and give recommendations for travel, workplace, houses of worship. They are dragging their feet. I am gently coaching Rochelle to go by her own instincts and not always yielding to the rigidity of the career CDC staff. • Had Zoom call with Gov. Dan McKee of Rhode Island asking advice about the next few weeks and his plans for the state PRESS: NBC “This Morning” with Savannah Guthrie; ABC “Good Morning America” with George Stephanopoulos; ESPN “First Take” TV with Max Kellerman, Stephen A. Smith, and Molly Qerim Rose (discussed my 5 favorite athletes); Podcast (“We Can Do This”) with Robin Roberts; CBS Evening News with Norah O’Donnell; Filmed Stephen Colbert for tomorrow night; MSNBC – Rachel Maddow March 12, 2021 – Global - USA Still plateauing: Briefed the Principals for our weekly briefing. I showed the replication cycle of SARS-CoV-2 and the vulnerable targets for direct anti-viral therapy David Kessler together with Rick Levin (formerly of Yale) made a proposal to provide through the congress 5 billion to me and NIAID to decide how we wanted to put together a “vaccine manufacturing plan that would involve everything from the fundamental research going into pandemic preparedness to the actual manufacturing of 300,000,000 doses of vaccine per year. This is an extraordinary offer then I will have to sit down with my team particularly John Mascola who was on the call with us to determine what aspect of this multifaceted plan that David proposed would be owned by us here at NIAID versus what we would give to HHS/ASPR/BARDA. I asked John to think about a team that we could put together in the beginning of the week to come back to David with a plan. Obviously, we will have to go 2 Francis Collins and thoroughly briefed him and get his buy in. PRESS: Zoom interview with Spike Lee for a documentary that he is filming; Politico by Sarah Owermohle and Erin Banco Fauci takes on a new role: Biden’s Covid whisperer Few others cast as long a shadow as Fauci — who over the last year has given America a crash course in epidemiology — especially with top health posts vacant. March 13, 2021 Global – 118,800,000/2,600,000; USA – 29,200,000/530,700 PRESS: Filmed with Mark Manucci for PBS March 14, 2021 – Global – 119,200,000/2,600,000; USA – 29,200,000/531,800 PRESS: NBC “Meet the Press” with Chuck Todd; CNN State of the Union” with Jake Tapper; Fox News with Chris Wallace; Gray TV “Full Court Press” with Greta Van Susteren March 15, 2021 – Global – 119,600,000/2,600,000; USA -29,300,000/532,400 Got call tonight from Larry Horowitz saying that Drew Weissman and his collaborator are planning to hold a press conference to discuss their studies in mice showing that an intramuscular injection of the mRNA vaccine leads to an immune response in the amniotic fluid of the pups in a pregnancy model. The FDA has already received the DART (Development and Reproductive Toxicology) studies from Moderna and Pfizer. According to Emily these studies were clean. The FDA has heard about the Weissman studies and feels that they are invalid. The two companies also feel that the studies are invalid. However, we cannot blow them off for obvious reasons. Even if the Weissman studies prove to be invalid, the fact that they are holding a press conference is going to create a huge mess. Hopefully, we can get this sorted out and have a repeat of studies to counter this finding. More later. Jeff Zients has heard about this and called me tonight at 9:30 PM. I told him we have to get the FDA out their showing that they have DART studies and explaining what their studies showed. Cases coming down: Yet Europe is seeing an upswing of cases resulting mostly from B.1.1.1.7: Today I received on a virtual zoom the Ivan Alan Award for Social Courage given by Georgia Tech University and it's President doctor Angel Cabrera. There was a video about my accomplishments and Rochelle Walensky joined us to celebrate the award. Rochelle was very generous in calling me her hero, her mentor, and her friend. I should point out at this point that Rochelle has become closer and closer to me in our very collegial relationship. In addition, I should point out that I have been getting a number of awards and prizes that I had not even documented in these notes. It is a shame that things are moving so quickly that I don't even have time to savor for a moment the many awards that I have been getting. PRESS: Did White House Press briefing today with Rochelle and Andy; March 16, 2021 – Global – 120,000,000/2,700,000; USA – 29,300,000/533,100 I took the led in pushing Janet Woodcock (FDA) and Rochelle Walensky (CDC) to make sure that all their ducks were in order. In fact, Janet checked and both Pfizer and Moderna had clean DART studies on record and CDC was following closely 2000 vaccinated pregnant women from a cohort of 31,000 and no red flags. All good so far. Participated in a very nice function at the National Cathedral where Francis Collins and I and Eliseo Perez-Stable gave brief remarks to various ministers from surrounding counties such as Montgomery, Arlington, Fairfax, District of Columbia, and others. The purpose was to have these African American pastors get publicly vaccinated in the cathedral so that their constituents would follow. It was one of many outreach efforts that Francis and I and others have been doing over the past months to stimulate interest in getting vaccinated. Summary of vaccines below: PRESS: MSNBC “Morning Joe” with Joe Scarborough; ABC “GMA3” with Jen Ashton; Wall Street Journal – CEO Council with John Bussey; Podcast with The Economist; National Cathedral Function with Press March 17, 2021 – Global – 120,400,000/2,700,000; USA – 29,400,000/534,100 Testified before the House Energy and Commerce Oversight & Investigations Subcommittee chaired by Diana De Gette (D-CO) with ranking member Morgan Griffith (R- VA). Good hearing with the usual snarkiness from David McKinley (R-WV) and Gary Palmer (R-AL). Several question centered around the GOP angry because the Dems are not giving Trump enough credit for the vaccine. It is reflecting what Trump has been saying to the media. Pres. Joe Biden sent me a thank you letter: Letter from president Joe Biden PRESS: NBC Late Show with Seth Meyers; White House Press Conference March 18, 2021 – Global – 120,900,000/2,700,000; USA – 29,400,000/535,200 Testified before the Senate HELP Committee chaired by Sen. Patty Murray (D_WA) and ranking Minority Richard Burr (R-NC). I had my typical fight with Sen. Rand Paul who insisted that masks were pure theater. I blew him away. After the Hearing, I briefed the POTUS and VPOTUS on Building Vaccine Confidence. Present virtually – me, Andy Slavitt, Marcella Nunez-Smith, and Courtney Rowe. In the Oval – Jeff, Natalie Quillian, Anita Dunn. Had call with Jeff, David K. Natalie, Anne Schuchat regarding alarming increase in NYC of B.1.526. Anne will call Zucker to suggest strongly to shut down bars and restaurants. We are afraid of a surge that we had expected since NYC tends to follow Europe, which is surging now following a plateau. SA giving vaccine to Canada and Mexico. For Mexico it is a quid pro quo to control immigration at the border. Also, AstraZeneca continues to mess up on their examination of data with the DSMB. They have shown extreme incompetence throughout this entire affair with mixing up clinical trial data in the UK to not having equity demographically in their USA trial PRESS: NBC “Today” with Savannah Guthrie; Did short TV hots with local stations in Alabama, Louisiana; North Carolina; South Carolina; CNN with Chris Cuomo March 19, 2021 – Global USA Still flattening. General worry about surge while several states are pulling back on mask mandates and other public health measures: PRESS: CBS “This Morning” with Gayle King; Snapchats with White House Comms; MSNBC “All In” with Chris Hayes March 20, 2021 – Global – 122,000,000/2,700,000; USA – 29,600,000/538,300 Had our newly established Saturday AM meeting with the medical team led by Jeff Zients to go over important issues. I brought up for the first time the issue of having Biden lead an effort to allow LMICs to produce their own vaccine. This could be a legacy issue for him similar to what George WQ. Buch did with PEPFAR. Cases starting to come up after the plateau: PRESS: NBC “Today Weekend” with Kristen Welker and Peter Alexander; March 21, 2021 – Global USA Still flat or slightly increased: While Europe continues to surge: And Brazil follows: March 22, 2021 – Global -123,000,000/2,700,000; USA – 29,700,000/540,000 Trump has been attacking me (and Deb Birx) in recent interviews on FOX News and “the Hill” (see below) saying that we were wrong most of the time. However, he actually says that I am a nice guy and he likes me. Big semi-scandal! AstraZeneca again messed up. Today was the day when they announced the data of their phase three clinical trial of a covid vaccine. The data showed a 78.9% efficacy with good efficacy against severe disease. They put out a press conference and press release and we followed with a press release that mirrored their release. As it turns out the data and safety monitoring board, which was getting impatient with them and was having trouble with their submission from the beginning, send them a harsh letter also addressed to me indicating that the data in their press release was not the most recent data an actually made the data looked more favorable. When the White House found out about this, it triggered a series of zoom calls with the comms team of the White House (Courtney Rowe et al) led by Jeff Zients. the final decision was that we would put out a press statement from NIAID in the middle of the night urging AZ to come clean with the DSMB and to straighten out their press release. See below the letter from the DSMB to me and AZ as well as our press release. final Concern over AZ press release.pdf NIAID Statement on AstraZeneca Vaccine Late Monday, the Data and Safety Monitoring Board (DSMB) notified NIAID, BARDA, and AstraZeneca that it was concerned by information released by AstraZeneca on initial data from its COVID-19 vaccine clinical trial. The DSMB expressed concern that AstraZeneca may have included outdated information from that trial, which may have provided an incomplete view of the efficacy data. We urge the company to work with the DSMB to review the efficacy data and ensure the most accurate, up-to-date efficacy data be made public as quickly as possible. Authorization and guidelines for use of the vaccine in the United States will be determined by the Food and Drug Administration and Centers for Disease Control and Prevention after thorough review of the data by independent advisory committees. PRESS: White House Press briefing – I presented the AZ results – 78.9% effective and 100% effective against sever disease – 0 in vaccine; 5 in placebo; BBC Radio World News; The Hill: Trump says Fauci 'a promoter more than anything' BY JUSTINE COLEMAN - 03/22/21 09:18 AM EDT 621 March 23, 2021 – Global -123,400,000/2,700,000; USA – 29,700,000/540,500 Did Governor’s Association call and gave them an update. Was introduced by Governor Cuomo who bragged about my New York City roots and that I am Italian-American. Did a Fireside Chat with the Forum of Small States – 100 of the smaller nations of the world. It was very enjoyable and they were totally appreciative of me and many said how popular I was in their country. The Irish Ambassador said I was “beloved in Ireland”. PRESS: ABC - Good Morning America with Robin Roberts; much press calls associated with the AZ issue described above; Entravision interview with Tsi-Tsi-Ki Felix from Univision; many print interviews related to the AZ issue (see above) Politico: Fauci: AstraZeneca needs to 'straighten out' vaccine data March 24, 2021 – Global -123,900,000/2,700,000; USA – 29,800,000/541,300 • Moncef Slaoui fired from GSK Board of Directors for sexual harassment charges dating back a few years • AZ continues to mess up on everything they seem to do. Hopefully, we will bring their miscommunication to an end as they finalize their discussions with the DSMB. • Got a call from Tom Frieden today about 2 issues: 1) Tom wants to know how I feel about working with Moderna in getting them to give up some intellectual property so that we can get vaccine to the developing world . He wants to see if I have a relationship with Moderna. If so, he would like to help with seeing if we can get Moderna to cooperate in building plants in the developing world to provide vaccine. Tom is going to send me some talking points that I might bring to Jeff Zients so that I do not go rogue on this without letting the administration know. 2) Tom is quite concerned that there is no decision yet on the commissioner of the Food and Drug administration. He is very much in favor of Josh Scharfstein over Janet Woodcock. He is trying to figure out ways to get the administration to seriously consider Josh. Apparently Ron Klain is concerned that Josh would have trouble getting confirmed by the Senate. Tom thinks that this is not an issue. PRESS: White House Press Briefing – most questions still about the AZ situation; Town Hall on Sirius XM “Rock the Bells” with LLCoolJ – guests – me, Marcella Nunez-Smith and DJ Jazzy Jeff; ENTERTAINMENT 03/24/2021 07:45 am ET Dana Carvey Goes Full ‘Godfather’ With Hilarious Dr. Anthony Fauci Impression “She was having sex with Dr. Anthony Fauci, now she’s banging a f**king star.” https://www.huffpost.com/entry/dana-carvey-anthony-fauci n 605b174dc5b66d30c74022cc The Brooch Is Back, Baby “These days, better than a tweet,” as one stylist put it. • • • • • • March 25, 2021 – Global - 124,200,000/2,700,000; USA – 29,800,000/543,000 After a Zoom meeting yesterday with the DSMB Chaired by Rich Whitley, it became clear that they are furious with AZ since they feel that the AZ people are “pathological liars”. It is a shame, because their vaccine is really a good vaccine; however, with their dishonest actions, they are casting discredit on the vaccine. Continues to plateau amid concerns for surge. Spring break is at hand. Variants in the USA: The plateau continues: PRESS: Bloomberg podcast; Podcast “Just Getting Started” with Rich Eisen; March 26, 2021 – Global – 125,200,000/2,700,000; USA – 29,900,000/544,000 Have continued to make virtual rounds on patients at the clinical center. I have not been indicating it in these notes; however, I have been regularly going to rounds at least once per week and occasionally two times per week. I want to make sure that I do not lose contact with what is going on in the trenches both with HIV and with COVID-19. Cases creeping up……. PRESS: White House Press Conference – I introduced the college campus transmission study (Larry Corey); March 27, 2021 – Global -125,800,000/2,800,000; USA – 29,900,000/545,300 PRESS: ABC – Good Morning America (Weekend); March 28, 2021 Global USA Going in the wrong direction: PRESS: CBS – Face the Nation with Margaret Brennan; Viewing of the Sanjay Gupta piece on CNN of the “6 doctors”; March 29, 2021 – Global – 126,900,000/2,800,000; USA – 30,100,000/546,700 • Considerable commenting rom the press about the Sanjay Gupta Special last night on the “6 Doctors” where me, Birx, redfield, Hahn, Giroir, and Kadlec were interviewed. I cam out fine, but the press criticized the rest , particularly Birx, Redfield and Hahn for using the interviews to try to rehabilitate their reputations that suffered by their performance during the Trump administration where they did not speak up against the misinformation from Trump (see below under “Press”) • Briefed the POTUS and VPOTUS on our usual weekly briefing. • President Trump lashed back in response to the CNN Special last night and wildly criticized Deb and I even making up stories that I bad-mouthed Deb all the time. He is truly an obnoxious adolescent. Below is his statement: – March 29, 2021 – Statement by Donald J. Trump, 45th President of the United States of America Based on their interviews, I felt it was time to speak up about Dr. Fauci and Dr. Birx, two self-promoters trying to reinvent history to cover for their bad instincts and faulty recommendations, which I fortunately almost always overturned. They had bad policy decisions that would have left our country open to China and others, closed to reopening our economy, and years away from an approved vaccine—putting millions of lives at risk. We developed American vaccines by an American President in record time, nine months, which is saving the entire world. We bought billions of dollars of these vaccines on a calculated bet that they would work, perhaps the most important bet in the history of the world. Dr. Fauci and Dr. Birx moved far too slowly, and if it were up to them we’d currently be locked in our basements as our country suffered through a financial depression. Families, and children in particular, would be suffering the mental strains of this disaster like never before. In a fake interview last night on CNN, Dr. Fauci, who said he was an athlete in college but couldn’t throw a baseball even close to home plate, it was a “roller,” tried to take credit for the vaccine, when in fact he said it would take three to five years, and probably longer, to have it approved. Dr. Fauci was incapable of pressing the FDA to move it through faster. I was the one to get it done, and even the fake news media knows and reports this. Dr. Fauci is also the king of “flip-flops” and moving the goalposts to make himself look as good as possible. He fought me so hard because he wanted to keep our country open to countries like China. I closed it against his strong recommendation, which saved many lives. Dr. Fauci also said we didn’t need to wear masks, then a few months later he said we needed to wear masks, and now, two or three of them. Fauci spent U.S. money on the Wuhan lab in China—and we now know how that worked out. Dr. Birx is a proven liar with very little credibility left. Many of her recommendations were viewed as “pseudo-science,” and Dr. Fauci would always talk negatively about her and, in fact, would ask not to be in the same room with her. The States who followed her lead, like California, had worse outcomes on Covid, and ruined the lives of countless children because they couldn’t go to school, ruined many businesses, and an untold number of Americans who were killed by the lockdowns themselves. Dr. Birx was a terrible medical advisor, which is why I seldom followed her advice. Her motto should be “Do as I say, not as I do.” Who can forget when Dr. Birx gave a huge mandate to the people of our Nation to not travel, and then traveled a great distance to see her family for Thanksgiving—only to have them call the police and turn her in? She then, embarrassingly for her, resigned. Finally, Dr. Birx says she can’t hear very well, but I can. There was no “very difficult” phone call, other than Dr. Birx’s policies that would have led us directly into a COVID caused depression. She was a very negative voice who didn’t have the right answers. Time has proven me correct. I only kept Dr. Fauci and Dr. Birx on because they worked for the U.S. government for so long—they are like a bad habit! Hospitalizations in people <65 years old: NEWS CLIPPING — WASHINGTON POST — CONDENSED (1 SOURCE PAGE) “PRESS: Had a “Roll Up Your Sleeves” chat for a PSA with Matthew McConaughey; MSNBC – Meg Tirrell; Washington Post: Feuds, fibs and finger-pointing: Trump officials say coronavirus response was worse than known 'That’s what…” March 29, 2021 at 8:09 a.m. EDT March 30, 2021 – Global USA I remain close to Deb Birx and she still communicates with me about he observations of how things are going. Below is an e-mail she sent me this morning: Testing rates continue to drop reaching under July levels despite substantial increase in number of test and testing supplies available. "Surveillance testing" or testing for this silent spread is so critical. The original rising test positivity in 18-24 is now 25-44 and rising. This is how all the prior surges occurred - due to vaccination level the fatalities maybe be less and the risk to the health system maybe less but the potential for significant increases in morbidity and long term impact of COVID 19 will be most evident in these age groups. Simply repeating the same public health messages without tailoring to specific age groups on specific media platforms where the message will be heard will not have the impact we need at this moment. Please take care of yourself. Deb Trump furious and being inarticulate in responding to our appearance on CNN Special. He is still talking about my errant pitch on opening day last year. He is rambling on. Meadows and Navarro are attacking me on FOX News. Navarro calling me a pathologic liar and calling the virus the “Fauci Virus’. The Trump team is really acting like a bunch of idiots. Peter Navarro being delusional again: Peter Navarro Slams Dr. Fauci: Virus Came From ‘Building’ He Built • Had Zoom meeting with Brazilian Minister of Health Dr. Marcello Queiroga. They need help from the USA because they are having a terrible problem and President Bolsonaro is very Trump-like and hurting the country with his approach. I offered to help by collaborating in research and discussing strategies. They really want vaccine from us, but the USA policy is that we will wait until we vaccinate our whole country before we give away excess vaccines. Unfortunately, that is all that I could offer them. They will get plenty of vaccine from Pfizer, AZ and J & J in late May and early June. After the zoom meeting, I received a note from one of their scientists – Dr. Jorge Kalil. He asked me to please help them and hang in their with them sine Bolonsaro in terrible and the Brazilian scientific community and Brazilian people hold me in high regard and they need me to stick up for them • Had Zoom meeting with Marshawn Lynch former running back for the Seattle Seahawks. Really interesting. A lot of street talk. It was actually a “PSA” for vaccinating African Americans • Had Zoom with D.L. Hughley – famous entertainer - another interesting chat on his show about African Americans and CVID vaccinations • WHO Report is out saying that it is “very unlikely” that the virus originated from a lab accident. There is concern that the Chinese had a lot of influence over what data the WHO group had access to PRESS: Did interview with Phil Rucker about his book on the Trump response to COVIDTrump lashes out at Fauci and Birx after CNN Politico: documentary The former president released a fact-challenged statement criticizing the former advisers after they criticized his administration’s pandemic response. Health Fauci and others look ahead to the holidays: Put another leaf in the table (QuickHoney for The Washington Post) By Marlene Cimons March 27, 2021 at 10:00 a.m. EDT March 31, 2021 – Global – 127,900,000/2,800,000; USA – 30,200,000/548,200 Still flat or inching up: • Had my every other week call with Chris Whitty and Patrick Valance of the UK. They are as concerned as we are about the potential for another surge. They are waiting on ordered doses of vaccine. • Did nice interview with Nick News for Children answering their questions about vaccines. • Did interview with Ricky Martin scheduled for Latin Grammy awards. Asked questions about vaccines. • I have been praising David Ho to the White House people regarding his studies of the variants. On that basis they are now probing whether he might be a good choice for FDA Commissioner. Source Dr M Gandhi UCSF: • PRESS:WJLA TV – discussed Nats baseball season; CNN with Chris Cuomo; Morning Joe’ Trashes Fox News Host for Allowing Navarro’s Unhinged Fauci Rant: ‘That’s Fireable’ April 1, 2021 – Global – 128,500,000/2,800,000; USA – 30,300,000/549,100 The Trump people including Meadows, Navarro and several other minor figures are going on a rampage on FOX news attacking me. Navarro calling me a psychopath and pathologic liar and Meadows blaming me for not weighing in on Children at the border. Amazing!!! Other news media are criticizing them strongly for doing this. • Had nice Fireside Chat with American Red Cross – Gail McGovern (CEO). The comments on the chat box were uniformly positive • Had a Zoom with Prize-winning artist Hugo Crosthwaite and Taina Caragol of the National Portrait Gallery. Taina will be commissioning Hugo to do a portrait of me for the National Portrait Gallery Collection. The whole process will take about 1 year. • Majorie Taylor Greene is trying to introduce legislation to fire me. Really!!!!: • Marjorie Taylor Greene: Fire Fauci and ban vaccine mandate and passport by Paul Bedard, Washington Secrets Columnist | PRESS: CBS This Morning with Gayle King; WXYZ TV Detroit; FOX L.A. TV “The Issue Is” with Elex Michaelson; NBC Nightly News with Lester Holt; NATs Podcast with Al Galdi and Mark Zuckerman. April 2, 2021 – Global – 129,3000,000/2,800,000; USA – 30,400,000/550,200 • Had nice Fireside Chat with Rep. Doris Matsui. • Am still being attacked by the far right wing including Senators (Lindsey Graham) and media (FOX). Interesting that they are asking me to explain the “crisis” at the border when that has nothing to do with me. • Had great interview with Neal Cavuto of FOX (see below under “Press”) in which he allowed me to counter all of the criticisms of people like Mark Meadows, Lindsey Graham, Navarro, etc. Navarro is calling me a pathological liar saying that I had nothing to do with the vaccine. He said this in response to my saying that one of the best choicesI made was to push ahead with Barney Graham’s collaborationwith Moderna. Obviously, Navarro has no idea about this and so has no idea what he is talking about • Another important issue – Robert F. Kennedy, Jr has written a book about me entitled “The Real Anthony Fauci”, which will almost certainly be a slanderous book. Am undecided about whether I should get lawyers involved PRESS: NPR Morning Edition with Noel King; NBC TV Detroit with Dr. Frank McGeorge; White House Press briefing; Politico Podcast with Jeremy Siegel; Interview with Business Insider; Interview with The Guardian; FOX News with Neal Cavuto. April 3, 2021 – Global – 129,900,000/2,800,000; USA – 30,400,000/552,800 Went to a “Spring celebration” at Bob Seder’s house to observe the Cherry Blossoms at Kenwood. I am a little nervous sine people were hugging and not wearing masks, although virtually everyone had been vaccinated. Still lingering at ~60,000 new infections/day: PRESS: CNN with Jim Acosta; April 4, 2021 – Global – 130,400,000/2,800,000; USA – 30,500,000/553,700 Things getting a bit scary. As B.1.1.7 becomes more dominant, we re seeing surges in some areas with younger people (even school kids) getting infected and hospitalizations increasing in relatively younger people. See below: Race between the vaccines (4 million shots administered yesterday!!!) and a new surge: April 5, 2021 – Global -131,000,000/2,900,000; USA – 30,500,000/554,100 Still putting pressure on me to switch to a single dose. Mike Gerson wrote an amazing column in the Washington Post about me: Opinion: Why tearing down Fauci is essential to the MAGA myth Opinion by Michael Gerson Columnist April 5, 2021 at 4:35 p.m. EDT MAGA political philosophy is not systematic, but it is comprehensive. Right-wing populism offers a distorted lens to view nearly all of life. Through this warped lens, progress toward equal rights is actually the oppression of White people. Free and fair elections, when lost, are actually conspiratorial plots by the ruthless left. But perhaps the most remarkable distortion concerns the MAGA view of covid-19. We have all seen the basic outlines of pandemic reality. Experts in epidemiology warned that the disease would spread through contact or droplets at short distances, which is how it spread. The experts recommended early lockdowns to keep health systems from being overwhelmed, and the lockdowns generally worked. The experts said Americans could influence the spread of the disease by taking basic measures such as mask-wearing and social distancing. The disease was controlled when people did these things. The disease ran rampant when they did not, killing a lot of old and vulnerable people in the process. There were, of course, disagreements along the way about the length of lockdowns and the form of mandates. But on the whole, American citizens have witnessed one of the most dramatic vindications of scientific expertise in our history. We have been healthier when we listened to the experts and sicker when we did not. This is the context in which the MAGA right has chosen to make Anthony S. Fauci — the director of the National Institute of Allergy and Infectious Diseases since 1984 — the villain in their hallucinogenic version of pandemic history. It is worth disclosing when a columnist has a personal connection to a public figure. I have known Fauci since I was in government during the early 2000s and watched him help create the President’s Emergency Plan for AIDS Relief. He is the best of public service: supremely knowledgeable, personally compassionate, completely nonpolitical, tenacious in the pursuit of scientific advancement and resolute in applying such knowledge to human betterment. He has no other ambition or agenda than the health of the country and world. Yet slamming Fauci was a surefire applause line at the Conservative Political Action Conference in February. Former Trump administration officials continue to target him. Republican members of Congress vie with one another to put Fauci in his place. For Trump officials, including Donald Trump himself, this makes perfect sense. If Fauci has been right about covid, then playing down the disease, mocking masks, modeling superspreader events, denying death tolls, encouraging anti-mandate militias and recommending quack cures were not particularly helpful. If Fauci has been right, they presided over a deadly debacle. When former Trump trade adviser Peter Navarro claims that Fauci is “the father of the actual virus” or former chief of staff Mark Meadows complains about Fauci’s indifference to the (nearly nonexistent) flow of covid across the southern border, the goal is not really to press arguments. It is to create an alternative MAGA reality in which followers are free from the stress of truth — a safe space in which more than half a million people did not die and their leader was not a vicious, incompetent, delusional threat to the health of the nation. Metaphorically (but only barely metaphorically), there is a body on the floor with multiple stab wounds. The Trump administration stands beside it with a bloody knife in its hand. It not only claims to be innocent. It claims there is no blood. There is no body. There is no floor. Congressional Republicans who criticize Fauci to prove their populist manhood are even more pathetic. Their self-abasement is voluntary. Watching Sen. Rand Paul (R-Ky.) debate science with Fauci during committee hearings is like watching Albert Einstein being disputed by his dry cleaner. Fauci is often reduced to making obvious points in a patient voice. Fauci deserves his Presidential Medal of Freedom just for his heroic forbearance. All these critics of Fauci have chosen to attack the citadel of science at its strongest point. With squirt guns. While naked and blowing kazoos. This useless exertion is somehow wrapped in the language of freedom. Freedom from the servitude of a piece of cloth on your face that might save your neighbor’s life. Freedom to light off fireworks below a potential avalanche. Freedom to store uranium in your backyard. Freedom to set fire to a crowded theater. Here is the reality of covid. It is not an easy thing to persuade hundreds of millions of people who feel perfectly healthy to wear masks, socially distance and get a vaccine injected into their arms. Fauci is dedicated to these goals. Anyone who purposely undermines them is a danger to the health and safety of their fellow citizens. Fauci is practicing epidemiology. His critics are practicing idiocy. Both are very good at their chosen work. PRESS: PIX 11 TV – New York City; April 6, 2021 – Global – 131,500,000/2,900,000; USA – 30,600,000/554,400 Had Zoom call with Pascal Soriot, CEO of AstraZeneca. He wanted to apologize for the miscommunications concerning the interactions between AZ and the DSMB a couple of weeks ago. He wanted my advice as to the best way forward. I explained to him that the most important thing for him to do would be to wait until the United States FDA comes out with their EUA. This would give the AZ product the validity that he is hoping for. I also mentioned that the confusion associated with the mixed up dosing situation associated with the Oxford group added a degree of skepticism about the entire AZ product. Best thing to do is to wait to see but the FDA says about the product. We seem to be stuck at around 60,000 per day: PRESS: ABC - Good Morning America with George Stephanopoulos; MSNBC – Morning Joe with Joe Scarborough; National Press Club Interviews; Fox Local TV Stations April 7, 2021 – Global -132,000,000/2,900,000; USA – 30,700,000/555,200 Terrific experience tonight – On my walk tonight with Christine through American University campus, on the way back we were met by throngs of American University students who illegally sitting on the grass enjoying themselves. In groups of three to five people they kept coming up to me wanting to get photographs and selfies. It was truly amazing as it went on for group after group after group. I must have posed for photographs with over 50 young kids from American University. Then, on the way down past Al Dente restaurant where we stopped to pick up a pizza, customers outdoors and inside the restaurant kept coming up to me asking to be photographed with me. My pizza took a long time to be ready and so I must have spent 15 minutes at the door of the restaurant allowing people mostly young kids but some adults to have selfies with me. The entire situation was culminated when I walked out of the restaurant with Andre Jacobs, my security man, and the entire population of people who are eating outdoors at Al Dente and Chef Geoff’s burst into a prolonged round of applause. It was really quite charming. Andre had gotten nervous throughout the entire situation since some people just ran up to me with their camera in their hand to get a selfie. Andre does not like people just running up to me an almost body slammed a man who meant well but who didn't realize that he had charged up to me. A memorable experience! PRESS: CBS “This Morning” with Gayle King; White House Press Conference (I discussed durability of vaccine-induced response; CNN with Anderson Cooper 360; April 8, 2021 – Global -132,700,000/2,900,000; USA – 30,700,000/556,100 Spoke with Olive Shisana and Morena Makhoana (Biovac) about setting up capability to manufacturing mRNA vaccines in South Africa. Olive claims to be the special advisor to President Cyril Ramaphosa of RSA. They want me to help to get Moderna to assist RSA in the form of Makhoana’s company Biovac to make mRNA vaccines for RSA. I taped my NAS remarks receiving their Public Welfare Medal. I spoke of my relationship with 7 Presidents including the difficult relationship with Trump. Met virtually for our regular weekly meeting with the POTUS and VPOTUS. Interesting situation. Marcella has been quite ill with inflammation of her brain stem (acute). She was quite incapacitated but is now improving rapidly on corticosteroids. She actually took the zoom call from her rehabilitation institution. We were joking that the loudspeaker might soon say that visiting hours are over and the president and vice president would hear it over the zoom. In addition Vivek was zooming from Miami and in the middle of the discussion a Peacock outside his window started making noise. What a scene. Daily cases still going up – 74.5 million yesterday: PRESS: RAI Italian TV; France 24 TV Interview New York Times (— Isabel Kershner): Israel marks Holocaust Remembrance Day with a virtual march and remarks by Dr. Fauci. Held virtually for a second year because of coronavirus restrictions, the event featured recorded remarks by two prominent figures in the battle against the coronavirus: Dr. Albert Bourla, a son of Holocaust survivors who is the chief executive of Pfizer, the pharmaceutical company that, together with BioNTech, produced a leading coronavirus vaccine; and Dr. Anthony S. Fauci, the leading infectious disease expert in the United States. April 9, 2021 – Global – 133,600,000/2,900,000; USA – 30,800,000/557,100 • Bad day – Chris brought her right arm (distal radius0 playing basketball with me for filming for Nat/Geo. Happened on the last 10 seconds of playing PRESS: Stephen Colbert had a skit about me and “the 4th Wave” - https://www.youtube.com/watch?v=xb0fB13xYYg April 10, 2021 – Global – 143,300,000/2,900,000; USA – 30,900,000/558,000 • Spoke again with Ari Emanuel and his team of Don Walker (lawyer, represents Obama and Clinton) and Jay Mandell (Mostly involved with books). They just wanted to check in to see if IU needed anything. I mentioned the situation with Robert F. Kennedy, Jr who is writing a book about me entitled “The Real Dr. Anthony Fauci”, which undoubtably will be a very scandalous book. Don Walker was adamant that we should do nothing about this since Bobby Kennedy has absolutely no credibility over the past several years. because of how crazy he has been acting Over the past several years. His strong recommendation is to just let it go. Don emphasized again how much money that I would be making with my lectures. I re emphasize to him that although I like the idea about making money, my most important goal is to do good , and that I would prefer to do several speeches pro bono depending upon who asks me. • Joan Baez will receive the Kennedy Center Award and there is a reception at the State Department on May 19th. She has invited me as her guest. What fun! Just spoke with her over the phone to check if there will be mask wearing since the press will have a field day if they saw me with Joan and we did not have masks. • We vaccinated 4.6 million people today Daile cases continue to rise – 81,400: A A April 11, 2021 – Global – 135,000,000/2,900,000; USA – 31,000,000/558,800 Sunday -quiet day. Catching up on writing Commencement address. Heard during my interview with MSNBC (see below) that Trump, while on FOX with Laura Ingraham said I was “full of crap” and that he never listened to me. Hasan came back on MSNBC and said that is why hundreds of thousands of people died, because he did not listen to me. Appasrently, Trump also made this comment during a fundraiser at Mar-a-Largo where he sharply attacked 2 people: me and Mitch McConnell. PRESS: MSNBC with Mehdi Hasan; April 12, 2021 – Global USA The Daily Mail in their reporting of the removal of Father Lahart from his position of President of Regis High School made sure to mention that I was an alumnus of the school (of course) (see below under Press. • Had a good Zoom meeting with Hon. Luigi Di Maio, Minister of Foreign Affairs and International Cooperation of Italy. He is in the USA to celebrate the 160th anniversary of Italian relations with USA. Good conversation. He wanted advice of the COVID-19 situation in Italy and Europe. Interesting how these foreign leaders want my opinion on these issues that have policy as well as public health implications. • Got call at 10:00 PM from Rochelle Walensky that the CDC and FDA had called a pause of the J & J vaccine due to 6 cases (all women – ages 18 to 48) of Cerebral Venous Sinus Thrombosis (CVST). I died, 3 hospitalized (2 in ICU), 2 discharged. Events occurred from 6 to 13 days after vaccination. CDC/FDA will do press conference tomorrow at 10:00 AM. PRESS: Daily Mail: Jesuit priest, 59, is removed as president of Manhattan's prestigious Regis High School - that Dr. Fauci attended - for 'non-consensual sexual misconduct with adult subordinates'; BBC radio interview (2 part series) on 40th Anniversary of recognition of AIDS pandemic; BBC - Radio “The Today Programme”; CNN “Situation Room” with Wolf Blitzer. I have been speaking about this all the time: April 13, 2021 – Global – 136,200,000/2,900,000; USA – 31,100,000/559,700 Jeff Z. calls me at 5:46 AM telling me to clear my calendar since the WH wants me out there with the press. See below – I engaged in the Jen Psaki Conference in the White House press room with Jeff Z. Obviously, this is a big deal even though it is a very rare event 6 cases in 6,850,000. I was on the Governors call with Rochelle and Jeff to explain the situation to the Governors. PRESS: White House Press Conference with Jen Psaki and Jeff Z.; CBS Evening News with Norah O’Donnell; NBC Evening News with Lester Holt; ABC Evening News with Linsey Davis; MSNBC with Chris Hayes April 14, 2021 – Global -137,000,000/3,000,000; USA – 31,200,000/560,600 There is a very important issue going on regarding a dispute between the vaccine Research Center an Moderna regarding the inventorship of the patent associated with the confirmation of the spike protein. For some strange reason Moderna wants to give us Co ownership of the patent but not inventorship of the patent. The VRC insists with good reason that we are true inventors of the patent. We had a conversation this morning among Francis Collins , myself , John Mascola, and Mark Rohrbaugh concerning any leverage that we might have over Moderna to pressure them in sharing the expertise of their technology with developing countries particularly in southern Africa. They have made a public statement that they will not interfere with any countries that want to use their technology. However, given the complexity of the technologies it is important that they pitch in and help the companies transfer the technology. Peter Staley and his activist friends are understandably pushing us to exert pressure on Moderna to transfer their technology to the developing world. The reason why the patent issue becomes relevant here is that the more control we have over what Moderna does the better we will be able to pressure them into the above. We decided that the best approach would be for Francis Collins and I to have a telephone call with the CEO of Moderna , Stephane Bancel and the POresident of Moderna, Stephen Hoge. Had call with Chairwoman Rosa DeLauro of the House Appropriations Committee. She wants to know what I think she should do with the $6.5 billion that they want to give to ARPA-H that would go to NIH. There is a fear among NIH grantees that the regular increases that NIH usually receives on a yearly basis will be diminished be 'cause the Congress is now giving the NIH $6.5 billion for “special projects”. They were thinking of giving the NIH $2.5 billion for the regular appropriation plus $6.5 billion for the special projects for a total of $9 billion, which is a lot. I suggested to Rosa that she called some of the money off the $6.5 billion and add it to the regular appropriation for the NIH. She seemed OK with this. I had recently received a letter from senator Lindsey Graham essentially demanding that as the chief medical advisor to president Biden, I go down to the border and look at the difficult health conditions there regarding the SARS coronavirus. Subsequent to that I received a letter from about 8 or 9 congressmen asking me to do the same thing. In fact, in his letter to me senator Graham said I was neglecting my responsibility as the adviser to the president if I did not go down to the border and report back on the “terrible conditions” on the border. This is clearly a set up trying to embarrass the president. Tomorrow I testify before the house Energy and Commerce Select Committee on COVID-19. Two congressmen who signed the letter will be there. I anticipate that they will ask me the same question about going to the border. Today I asked Jeff Zients to ask Ron Klain and the president if it is OK for me to say that since I am the chief medical advisor to the president I would be happy to go to the border if the president ask me to. However, with all due respect I am not the adviser to the Congress but to the president. I will do what he asked me to do, and again with all due respect not what the Congress asks me to do. Ron Klain and the president are OK with this approach. • Got call from Jeff that the Oxford group were coming out with a paper tomorrow saying that in a large data base they found that mRNA vaccinbes had even more thrombosis than AZ. Obviously, bullshit. They did not look for thrombocytopenia and so the observation is invalid. Also, not surprising fr the Oxford group sine their vaccine is in trouble and I would not be surprised if they were trying to disparage the other vaccines. PRESS: MSNBC – “Morning Joe” with Willie Geist; CNN “New Day” with John Berman; NBC “Today” with Savannah Guthrie; White House Press Conference (regular 3x/week). Did 4 separate Local TV hits with Cameron Webb in Mississippi Stations April 15, 2021 – Global – 137,900,000/3,000,000; USA – 31,200,000/561,400 Still hanging around 70,000/day: Major clash with Rep. Jim Jordan during the House Energy and Commerce Select Committee on COVID-19 chaired by Jim Clyburn and Steve Scalise as Ranking Member. Jordan did his usual aggressive asking me multiple questions without giving me a chance to answer. He was harping on my giving him a definite date when he can get his “liberty and freedom back” that I was restricting him from. I insisted that this was not a matter of liberty and freedom, but was a public health issue.We had a heated discussion. I finally told him that he was “ranting”. In addition, I told him that he was making this a personal issue. He denied that, but I insisted that he was indeed making it a personal issue. Finally, when his time was up he kept on talking and representative Maxine Waters told him to shut up. PRESS: All over TV in my clash with Rep. Jordan at the E and C Hearing – CNN covered it extensively and Jimmy Kimmel had it in his monologue; Reuters TV interview with Julie Steenhuysen; Had conversation with member of NY Times editorial board member Jeneen Interlandi about 1 dose versus 2 doses. She seemed to side with me. April 16, 2021 – Global – 138,700,000; USA - • Andy Slavitt remarked how proud of me he was as he watched me respond to Jim Jordan. • Fox News is attacking me abut my interchange with Jordan, BUT MSNBC is attacking FOX for attacking me. Example: • Scarborough slams Jordan for spreading 'lies' about Fauci: 'It's sheer idiocy' • By Cameron Jenkins - 04/16/21 11:38 AM EDT 410 • In the Instagram with Tyra Banks (see below) she was wonderful. People who wrote comments were 95% positive, but some were really mean and vicious statements about me and Tyra. One person said that Tyra was sexy, but I was even more sexy than she was. She read it and put a big smile on her face and said that she agreed with that but then beautifully and gently shot this down by saying: “Dr. Fauci, that is true and my mother is in love with you” . Zing PRESS: Veja Magazine (Brazil) – reporter – Julia Teixeira Braun; Facebook – “Now This” with Zinhie Essamuah; Instagram with Tyra Banks (she was absolutely fabulous); MSNBC “Reid Out” with Joy Reid; April 17, 2021 – Global – 139,500,000/3,000,000; USA – 31,400,000/563,200 Cases continue to creep up in certain states (>35). Had nice dinner over Ellen Sigal’s home with Diana DeGette, Chair of the House Energy and Commerce Subcommittee on Oversight and Investigations. Dana Bash sent me a text: “I just watched the whole Jordan thing. Again, you’re a better man than I…. As our friend Wolf Blitzer said to me yesterday – no one would have blamed you if you said simply “Mr. Jordan, go f--- yourself” PRESS: Had another of several interviews at home with Mark Manucci for the PBS Masters Documentary April 18, 2021 – Global – 140,300,000/3,000,000; USA – 31,400,000/564,000 • David Axelrod sent me a text saying that his wife Susan says that I look 10 years younger since the change of administrations. • I received a text from Dana Bash pointing out that Vanity Fair recently had a headline that said: Jim Jordan trips over his own asshole trying to debate Anthony Fauci. PRESS: ABC This Week with Martha Raddatz; NBC Meet the Press with Chuck Todd; CBS Face the Nation with Margaret Brennan; CNN State of the Union with Dana Bash; MSNBC The Sunday Show with Jonathan Capehart; April 19, 2021 – Global – 141,100,000/3,000,000; USA – 31,500,000;564,300 Today is the day (April 19) when the POTUS said that everyone 16 years of age and older is now eligible to receive a vaccine. No more restrictions to priority groups • Kate Berner sent me a note saying that I was “outstanding” at the White House pressor. • I get a lot of FOIA requests regarding my financial statements as well as regarding text messages , written correspondence, and phone calls . These are clearly directed at trying to catch me at something usually from conspiracy theorists but also from Republican operatives. The most recent FOIA requests have been for any text messages between me and Susan Rice, Ron Klain, Anita Dunn, and Kate Bendingfield. The most recent one has come from the Republican National Committee in the person of Nicholas Erickson. Clearly, I have become a prime target of the Trump Republicans • Had great conversation with Amb. Katherine Tai who is the US Trade Representative. The ambassador was extremely excited about partnering with me in trying to get a waver of the patent restrictions for the production of vaccines by the developing nations. She is also very well aware that the important issue is to transfer the technology and the expertise even after the wave it has occurred. I had mentioned to her that I would soon meet with the CEO of moderna to try to get him to cooperate and transferring this technology. We left it that we shall get back together after she does some work on this problem. In the arena of small world things, the ambassador mentioned to me that her mother was a scientist here at NIH and that she is a child was put Into the NIH daycare center. I believe that I will get along very well with her. PRESS: NPR -Morning Edition with Rachel Martin; CBS “This Morning” TV with Tony Dokoupil; Rickey Smiley Radio; Enrique Santos Show (TV); The Morning Hustle Show” (Radio) with Headrack; White House Press Briefing; did loal TV hits in Indianapolis, Jacksonville, FL, and Birmingham, AL; Australian ABC News Radio April 20, 2021 – Global USA Maybe coming down a bit: • I was on the governor’s call today. One of the questions that came up today was why we still have a mask mandate for outdoors. I agree that this is a problem. Rochelle answered that CDC is re-examining this issue. I feel that we should obviously say that if a person is out alone outside, they do not need to wear a mask. • Important issue brought to my attention regarding potential far right wing coming after me. It appears that a few of the far right grantees of NIAID are joining with the radical right wing people in the public as well as people in the Congress such as congressman Jim Jordan and Senator Rand Paul to try and connect me with the virus from WUHAN. In fact, David Morens has heard that these people are trying to “bring me down” .. They are saying that I deliberately worked with the Chinese together with Peter Daszak to create a virus that would be released to the world. This sounds very much like a way-out conspiracy theory, which it is. However, there are enough crazy people around to make this a problem. I am going to arrange for a phone call with David in order to determine more details as to what is going on. It is my suspicion that some of these so-called NIAID grantees are Imperiale and Rich Ebright. They have been complaining about gain of function research for years. They have even publicly made the claim that when they speak against anything that I want I will prevent them from getting their grants. Everybody knows that this is absolutely preposterous, but they in fact are preposterous. Let us see if in fact these are the villains. PRESS: BBC Radio – 2nd installation of a story that BBC is doing on the history of HIV/AIDS; Columbia TV -NTN 24; Instagram with Aidan Galassetti April 21, 2021 – Global USA Cases back up again a bit – 57,000: Had an important call without colleagues in South Africa another southern African countries to discuss the possibility of conducting a clinical trial with the moderna m RNA vaccine. The issue is that they are in desperate need of a vaccine since the AZ vaccine does not work against the variant B.1.351. In addition, the J&J vaccine that appears to do well against the South African variant will not be ready for at least several months and there is a window of opportunity to do a clinical trial with a delayed placebo crossover on 14,000 people. The issue is that the South Africans particularly Glenda Gray and Linda GAIL Becker need to show that the mRNA vaccine is effective in South Africa particularly among persons living with HIV. David Kessler who will be key in getting the product to South Africa was on the zoom. I feel that this is definitely worthwhile doing since if we can prove that the mRNA vaccine works in South Africa, then Glenda feels that they can convince the African countries to make a major investment in buying the mRNA vaccine. On the phone call were the following : Glenda Gray, Linda-Gail Bekker, Philip Kotze, Mike Chirenje, Tulio de Oliveira, Larry Corey, David Kessler, Emilio Emini, Cliff Lane, John Mascola, Carl Dieffenbach, Emily Erbelding, among others. Beautiful situation of my impact on an autistic child. See attachment: 399065 Kirkland #2 corr.pdf • I presented nomination of Barney Graham to NAS Section 44. Bob Gallo made a random and completely unnecessary potentially negative comment about Barney while presenting another candidate (Ray Schinazi) Hello, my name is Nicholas Wilson and I am a senior at Arizona State University studying history, Political science, and education. This year has been tough, but I got the vaccine. I wanted to thank Dr Fauci for all his hard work and to commemorate this modern marvel I got a tattoo. I hope you enjoy. PRESS: Hispanic TV hits: Despierta America; Actualidad Radio – Juan Gomez and Roberto Rodriguez (South Florida); CNN Newsroom with Victor Blackwell; NBC TV – Dallas with Julie Fine; April 22, 2021- Global USA Note the difference in mask mandates between the red and blue states: • I participated in an iPC meeting today chaired by Beth Cameron of the National Security Council. The purpose of the meeting was to figure out how we could ask for $30 billion for pandemic preparedness and put it into the American Jobs Plan bill. The NIH had put in a proposal through HHS of close to $30 billion for our needs alone. There appears to have been some confusion as to the fact that HHS did not send down our request to the NSC in time for inclusion in the NSC document that was being discussed at the meeting. This led to a lot of running around on my part and on the part of Francis Collins and Larry Tabak to figure out how we can get our request properly represented in the discussion. It seemed to have worked out OK as I together with Eric Lander made a presentation to the IPC that indicated the broad scope of our needs without necessarily mentioning the budget. It was one of those times where you walk in the morning and find out that you have to do something that nobody told you about until one hour before you had to do it. I refer to my need to make a presentation on behalf of the NIH to the IPC. • • Did a Fireside chat with the American College of Physicians. The chat was chaired by Dorilyn Moyer. In addition, I was presented with the 2021 Boyle award from the American College of Physicians. To illustrate how flooded I am with things , I had no idea I was being awarded the Joseph F. Boyle award and I had to make comments accepting the award. I had to quickly scramble to get Kim to go on the Internet and find out just what the Joseph F. Boyle award is. As it turns out it is an award bestowed upon a current or former government official who has provided outstanding public service to improving the delivery of health care. Again, I am running at such an amazingly fast pace that I do not know what I am about to do until I sit in front of the zoom and do it. • Met by Zoom with POTUS and VPOTUS for our regular weekly update. PRESS: KSNV- TV – Las Vegas with Jeff Gillian; KABC - TV – Los Angeles with Denise Dador; KCBS Radio – San Francisco with Mike DeWald April 23, 2021 – Global – 144,400,000/3,100,000; USA – 31,700,000/567,400 Still plateauing, but the 7-day average is slightly down (~10%): Presented before the Lasker Board with Elia Zerhouni, Peggy Hamburg, Al Reese, Joe Goldstein and I mentioned when they said I was their hero, that I was also a “target” for some. They immediately said “We have you back”. Important in light of the antipathy of many against me. PRESS: White House Press Conference; Online – TV - The Birmingham News; Huntsville Times and Mobile Press-Register with Ivana Hrynkiw; MSNBC with Ayman Mohyeldin; PBS Newshour with Judy Woodruff; MSNBC Town Hall with Alicia Mendez and Rep. Raul Ruiz April 24, 2021 – Global – 145,200,000/3,100,000; USA – 31,800,000/568,200 Real crazy anti-Fauci stuff going on. Two authors named Steve Deace and Todd Erzen wrote a book about me entitled “Faucian Bargain” - The most powerful and dangerous bureaucrat in American history. It is a cheap paperback of 179 pages which I will not even read but it contains the same sort of nonsense that the other conspiracy theorists have been saying about me. It is really getting worse and worse in the number of crazy people who are buying into this conspiracy theory and so now we have the book by Robert F Kennedy junior and this book by these two guys as well as a number of right wing columnists such as Josh Rogin , as well as multiple commentators on Fox News who spend much of their time making me out to be the worst villain in the world and or trying to discredit me. Had important meeting with Jeff Zients, David Kessler, Francis Collins, Car Dieffenbach, Natalie Quillian, Dina Halme, Lauren …. To discuss the $3.15 billion for the COVID-19 antiviral program. There was considerable concern on our part that we would not be getting the full amount of money for this very important program to develop antiviral drugs for COVID-19. Omb has indicated that they may use some of that money for the purchase of booster doses for the vaccine program. We called this meeting together in order to get Jeff to support the fact that this is an incredibly important program for the current and future pandemics. Carl describe the program very well and I believe that we have convinced Jeff to strongly support us. See below power for a detailed description with slides: We still are doing pretty well against the current variants with regard to our vaccines; Eric Topol’s take on Variants: India is exploding with cases with the new variant B.1.617 (see below): We have a serious problem of optics regarding our not sending to needy countries any of the AZ doses of vaccine at the same time as we have a greatest supply than demand right now. There is growing sentiment throughout the developing world at the United states is being unethical and amoral in not giving away doses of vaccine from AZ that we know we will never use. This is particularly the case with India that is really exploding with infections. The are now having >300,000 infections per day. One can say that you cannot do this since AZ has only been approved under an EUA. However, there are certainly ways that we can get around this. The bottom line is that we are looking very bad in the eyes of the low and middle income countries. I will continue to bring this up to Jeff Zients and other leadership. In fairness to our position, we do not really have a lot of doses of AZ vaccine hang around unused. Novovax does not come online until around June, and so the argument that we want to secure enough doses for ourselves including boosters can be defensible. Unquestionably, this is a very difficult situation. Amazing, but Vivek called me right after I wrote this with the same feeling as expressed above. We tried to get a meeting with Vivek, me, Rochelle, and Jeff to discuss how we are going to handle the situation with regard to India , particularly on the Sunday TV shows that Vivek and I will be on tomorrow. Unfortunately, Jeff could not squeeze in a meeting. PRESS: Huffington Post: Anthony Fauci Delivers Short, Sharp Shutdown Of GOP Senator’s Vaccine Doubt Bluster April 25, 2021 – Global - 146,100,000/3,100,000; USA – 31,800,000/569,000 We had an important zoom talk at 11:00 AM today with Jeff, me, Rochelle, Natalie, and Vivek regarding our response to the crisis in India. See above. Jeff is sensitive to our concerns and indicated that Jake Sullivan in NSC is already involved in sending materials to India including filters for vaccine production, oxygen supplies, ventilators, therapeutics such as remdesivir and favipiravir, sedation meds, test kits, and PPE. I brought up the fact that the real issue is sending our doses of the AZ vaccine that we now have on the shelf. The issue is that we keep saying that we will do this when we are confident that we will be able to vaccinate all Americans. However, this is somewhat contradictory since we have already publicly said that we have enough vaccine from Moderna and Pfizer to vaccinate everyone in the country who needs to be vaccinated. And so, it is clear that we're not going two need the AZ vaccine. Thus, why not send it off to India and other countries as soon as possible? Jeff and Natalie agreed and we will push this agenda soon. Release today! - National Security Advisor Jake Sullivan spoke by phone today with National Security Advisor Ajit Doval, expressing deep sympathy for the people of India following the recent spike in COVID-19 cases. Mr. Sullivan affirmed America’s solidarity with India, the two countries with the greatest number of COVID-19 cases in the world. Building on the seven-decade health partnership between the United States and India —including battles against smallpox, polio, and HIV — they resolved that India and the United States will continue to fight the global COVID-19 pandemic together. Just as India sent assistance to the United States as our hospitals were strained early in the pandemic, the United States is determined to help India in its time of need. To this end, the United States is working around the clock to deploy available resources and supplies. The United States has identified sources of specific raw material urgently required for Indian manufacture of the Covishield vaccine that will immediately be made available for India. To help treat COVID-19 patients and protect front-line health workers in India, the United States has identified supplies of therapeutics, rapid diagnostic test kits, ventilators, and Personal Protective Equipment (PPE) that will immediately be made available for India. The United States also is pursuing options to provide oxygen generation and related supplies on an urgent basis. The U.S. Development Finance Corporation (DFC) is funding a substantial expansion of manufacturing capability for BioE, the vaccine manufacturer in India, enabling BioE to ramp up to produce at least 1 billion doses of COVID-19 vaccines by the end of 2022. Additionally, the United States is deploying an expert team of public health advisors from the Center for Disease Control (CDC) and USAID to work in close collaboration with the U.S. Embassy, India’s health ministries, and India’s Epidemic Intelligence Service staff. USAID will also quickly work with CDC to support and fast-track the mobilization of emergency resources available to India through the Global Fund. I had an important zoom meeting today with Larry Corey an Emilio Emini about the same subject as above , namely, how the United states can play a major proactive role in getting mRNA vaccines to the developing world. In our discussion, it became clear that there are immediate needs as mentioned above; however, there is also the immediate need of getting vaccine doses to lower and middle income countries. The United states could exert leadership in pressuring Moderna and Pfizer to scale up their vaccine production and sell it two developing nations at cost for production which is approximately $6 per dose as compared to the $30 produced that we are currently paying here in the developed world. Apparently there are liability issues that the pharmaceutical companies are concerned with. These revolve around the fact that although the United States government can indemnify the companies against lawsuits here in the United states the companies feel that they are liable to being sued for adverse outcomes by people in the countries to whom they're providing vaccine. Some mechanism needs to be worked out to address this concern. I have asked Emilio and Larry to put a one pager together summarizing our discussion so that I can bring it to Jeff who could bring it to Ron Klain who could bring it to the president. More later. Breakthrough infections are very rare: NEWS CLIPPING — WASHINGTON POST — CONDENSED (3 SOURCE PAGES) “Front page of the Washington Post had a major article on the drastic situation in India and reported on the universal criticism there is of the United states in not doing something about it right…” He’s generally cautious, and the people constructing scorecards of his correct and incorrect predictions disingenuously conflate him with Oscar-pool contestants placing bets on best supporting actress. Fauci wasn’t making wagers, wasn’t saying sooths. He was giving his best educated guesses, based on what was knowable at that juncture. His guesses evolved as his — and our — education improved. Informed guidance like his is better than no guidance at all, and information isn’t static. Over three and a half decades as the director of the National Institute of Allergy and Infectious Diseases, Fauci, now 80, has advised and earned the trust of Republican and Democratic presidents. He managed somehow to correct Trump and yet not be replaced with a sycophant who would have fed the former president’s delusions and further endangered Americans’ lives. That’s more than public service. That’s magic. And he was thanked for it with death threats, issued not just to him but also to his family, and with a piece of mail that, when he opened it, sprayed an unidentified white powder all over him. He sat there covered in it while a hazardous materials team swept in. “My wife and my children were more disturbed than I was,” he told The Times’s Donald McNeil in an interview in January. “I looked at it somewhat fatalistically. It had to be one of three things: A hoax. Or anthrax, which meant I’d have to go on Cipro for a month. Or if it was ricin, I was dead, so bye-bye.” Why didn’t he say bye-bye to this awful role and the nonstop vitriol, given how much he’d contributed to the country from the AIDS epidemic onward and given that most 80-year-olds like him are taking it just a tad easier? “I always felt that if I did walk away, the skunk at the picnic would no longer be at the picnic,” he told McNeil, referring to his ability to challenge the happy talk of Trump administration officials who wanted simply to wish the coronavirus away. “Even if I wasn’t very effective in changing everybody’s minds, the idea that they knew that nonsense could not be spouted without my pushing back on it, I felt was important. I think in the big picture, I felt it would be better for the country.” He felt correctly. That assessment would be self-aggrandizing only if it weren’t true, just as his many media interviews would smack of preening if there weren’t such clear educational purpose to them. The key to his temperament — and to the greater measure of humility than of hubris in it — lies in how, even now, he talks about Trump. Although Fauci has ample cause for venom, there’s little trace of it in his words. He faults Trump without mocking him. That shows a discipline that’s rare. I never achieved it. Sure, Fauci won a $1 million prize, but he didn’t agitate for it, and there isn’t a doubt in my mind that during many points over the years, he could have left government for the private sector, traded on his stature and connections, and become an exponentially wealthier man. He refrained from that as surely as he has from the pettiness that most of the rest of us can’t resist. “He has no other ambition or agenda than the health of the country and world,” wrote the Washington Post columnist Michael Gerson, who, as a senior official in the George W. Bush administration, became acquainted with Fauci. I understand — and personally feel — any American’s frustrations with the continued caveats regarding masks and gatherings and such. But it’s Fauci’s mandate to urge the safest possible behavior. I understand how maddening it can be to get different answers at different times. But uncertainty is the nature of this beast. I don’t understand the rage at a remarkable public servant, and I’ll let Gerson have the last words on that. “Fauci is practicing epidemiology,” he wrote. “His critics are practicing idiocy. Both are very good at their chosen work.” April 26, 2021 – Global – 146,800,000/3,100,000; USA – 31,900,000/569,300 I had an interesting conversation with Vivek late last night. He called me up after we had a meeting with Jeff and the medical team concerning the guidelines that the CDC was about to put out regarding the wearing of masks outdoors as well as indoors in vaccinated versus unvaccinated people. Vivek was concerned about something that I had been concerned about for a long period of time. That is the CDC often puts things out that none of us can really adequately defend because it is either unclear or just does not make any sense. This is exactly what happened last night when Rochelle presented a color-coded guideline that no one could really understand . Yet, the CDC was about to put it out. To her credit, Rochelle ran it by the medical team. Rochelle is in a difficult position since she is new in the job and is reluctant the contradict her team which has been in place for decades. That is really the fundamental problem of the CDC. For as long as anyone can remember they are isolated in Atlanta, are extremely arrogant, and are offended if anyone on the outside asks to see their material before they actually put it out. They are very close-to-the-vest. I have known this for some time as have my colleagues here at NIH. However, it is interesting and in some respects gratifying that Vivek has now picked that up on his own and fully realizes the problem. • Did Town Hall with the Harvard T.H. Chan School of Public Health led by Sam Baker of Axios and included Mary Bassett, Karen DeSalvo, Garth Graham, and Michael Mina • Did Principal’s meeting with Cabinet. Had a wonderful zoom session with President Obama - I was on a zoom one on one discussion with President Obama for the purpose of encouraging people to get vaccinated. He was his typical engaging and highly intelligent self. Similar to what my experience was when he was in the White House, he had a perfect grasp of all of the details surrounding vaccines. It just reminded me of what an incredible person he is and what an amazing president he was. We joked around a lot about what I had gone through over the last year. I even mentioned to him that during an interview with some of the sports reporters I had mentioned that if I went one on one with him in basketball even though he is very tall and has a great jump shot, I still would be able to dribble around him since I'm so fast. He started to laugh and said that I better stop talking trash to him because now he's mad and if we ever get to play together he'll block every one of my shots. The interview was really a terrific experience. PRESS: Newsy TV Interview with Kellan Howell; NBC TV interview with Lester Holt for the Aspen Institute Online; April 27, 2021 – Global – 147,500,000/3,100,000; USA – 31,900,000/569,800 Coming down. 2nd day in a row in the 30s: PRESS: Sanjay Gupta podcast; IAS Podcast on 40 years of HIV; White House Press Conference (spoke on variants); WTOP Radio with Megan Cloherty; NY Times Editorial Board; NPR – “All Things Considered” with Mary Louise Kelly; Windy City Times interview – 40 years of HIV; Interview for Research!America with Opray Winfrey; MSNBC with Chris Hayes; April 28, 2021 – Global -148,300,000/3,100.000; USA – 32,000,000/570,400 Letter to Dr. Collins from Republican Congressmen Cathy McMorris Rodgers, Brett Guthrie, and Morgan Griffith asking many questions about the origin of SRAS-Cov-2. Clearly trying to dig up dirt and implicate the NIH in collaborating with the Chinese leading somehow (???) to the release or escape of SARS-CoV-2 from the Wuhan lab: SKM_C754e2104280 6490.pdf I am starting to put much more pressure publicly on pushing for a global response to the pandemic by urging us to help low and middle income countries with focus now on Indias. See today’s Washington Post: Covid-19 live updatesGlobal pandemic needs a more global response, Fauci says, amid record-breaking deaths in India Latest: How to access the risks of returning to the gym The Fauci “thing” is as thick as ever: • Francis and I were on a Zoom call with Stephane Bancell (CEO of Moderna) and Stephen Hose (President of Moderna). We discussed two things: the fact that we felt that Moderna should be doing more to provide vaccine for low and middle income countries. We wanted them to help out by transferring their technology two nations such as Senegal , Ethiopia, and countries in South America in order to allow those countries to make vaccines for themselves. They felt that this is something that they would likely do but that it would take at least two years for those countries to stand up their plants even if the technology was transferred. Their idea was a two-pronged approach. First, they are ramping up their capability of producing vaccine and by the end of 2022 they feel that they will be able to produce a total of 3 billion doses. They would be happy to make those doses available at a lower tiered price to the developing world. In addition, they agreed that they would participate in a longer range plan to transfer technology 2 low and middle income countries to make their own vaccine. In addition, Frances and I spoke about the patent dispute between the NIAID Vaccine Research Center and Moderna. The story is that the lawyers of Moderna feel that the VRC people such as Barney Graham an others technically should not be inventors on the patent for the discovery of the vaccine. We strongly disagree with that an as a matter of fact so do Stephane and Stephen. they realize that it is unfair to exclude us from the patent; also it would be a public relations disaster for them if they excluded us. They promised that they would get this resolved soon. It is clear that Pfizer can do the same thing. In fact, Pfizer can likely produce 3 billion doses by the end of this year and even more next year . If this is possible which I believe that it is, then we could probably vaccinate the entire world that wants to be vaccinated within the next year and a half. PRESS: NBC “Today” with Savannah Guthrie; CNN with Jim Sciutto; Vaccines Appear to Wall Street Journal – Robbie Whelan - Be Slowing Spread of Covid-19 Infections With more than 37% of U.S. adults fully vaccinated, Anthony Fauci expects case numbers to drop significantly April 29, 2021 – Global -149,200,000/3,100,000; USA – 32,000,000/571,300 MMWR: Linked Clusters of SARS-CoV-2 Variant B.1.351 — Maryland, January–February 2021 Back up again to 53,000/day: • Did a zoom podcast interview with Quinn Bradlee (son of Sally Quinn and the late Ben Bradlee). He is disabled and Sally asked me to do this. I could not refuse since I admired Ben so much and he was always so gracious and kind to Chris and me. He was so excited to have the opportunity to interview me. Important Issue: Francis Collins forwarded an email to me (see below )which triggered a concern about whether the Indian variant – B.1.617 was resistant two antibodies induced by vaccines. I forwarded this email to the medical team including Jeff Zients and Rochelle Walensky. Rochelle called me up and mentioned that her colleagues in Boston including those at the Broad Institute as well as Dan Barouch were finding that the Indian variant could be very problematic with regard to its resistance to vaccine induced antibodies. In addition, I spoke with Bob Seder and the work that he has been doing with monkeys also indicates that B.1.617 could be very problematic. Then, Jeff Zients called me up together with Natalie Quillian and feels that we should call a temporary halt on travel from India until we sought this out and based on the information that I sent him. This is a critical decision since if we don't block travel from India and things look bad later on we will be sharply criticized for not doing so. However , if we do block travel, there will be those who criticize us for doing so. This is very similar to the deliberations that we had during the Trump administration regarding China, the Eu and the UK. SEE E-MAILS BELOW starting with the e-mail that I sent to the medical team of Walensky, Vivek, Bechara, Slavitt, Zients, Nunez-Smith. (Rochelle subsequently forwarded it to Dawn O’Connell at HHS) Team: Please see e-mail below from Dr. Venkatachalam to Francis Collins. Although this is still at the level of anecdote, I am hearing from people who are doing studies in vitro that the B.1.617 variant is at least as concerning as the B.1.351. We should discuss this at our next meeting. Best, Tony Anthony S. Fauci, MD Director National Institute of Allergy and Infectious Diseases Building 31, Room 7A-03 31 Center Drive, MSC 2520 National Institutes of Health Bethesda, MD 20892-2520 Phone: (301) 496-2263 FAX: (301) 496-4409 E-mail: afauci@niaid.nih.gov The information in this e-mail and any of its attachments is confidential and may contain sensitive information. It should not be used by anyone who is not the original intended recipient. If you have received this e-mail in error please inform the sender and delete it from your mailbox or any other storage devices. The National Institute of Allergy and Infectious Diseases (NIAID) shall not accept liability for any statements made that are the sender's own and not expressly made on behalf of the NIAID by one of its representatives. From: Collins, Francis (NIH/OD) [E] <collinsf@od.nih.gov> Sent: Thursday, April 29, 2021 5:56 AM To: Fauci, Anthony (NIH/NIAID) [E] <afauci@niaid.nih.gov>; Lane, Cliff (NIH/NIAID) [E] <clane@niaid.nih.gov>; Mascola, John (NIH/VRC) [E] <jmascola@mail.nih.gov>; Erbelding, Emily (NIH/NIAID) [E] <emily.erbelding@nih.gov>; Wholley, David (FNIH) [T] <dwholley@fnih.org>; Menetski, Joseph (FNIH) [T] <jmenetski@fnih.org> Subject: FW: Concerning news about the B.1.617 variant from India and your view More concerns about B.1.617 and the effectiveness of vaccines. From: Venkatachalam, Sundar (NIH/NCI) [E] <sundar.venkatachalam@nih.gov> Sent: Thursday, April 29, 2021 4:53 AM To: Collins, Francis (NIH/OD) [E] <collinsf@od.nih.gov> Subject: Concerning news about the B.1.617 variant from India and your view Dear Dr. Collins, I hope this message finds you and your family well. I wanted to bring to your attention about a public health like message circulating among the Indian diaspora in the New Jersey area. Apparently, parents visiting from India who tested negative before their flight in India have come down with Covid (the message claims it is the B.1.617 variant from India) after 10 days. They have also visited a variety of get togethers, temples before the symptoms arose. This variant was detected in the Bay Area earlier this month and the CNBC article quotes Dr. Pinsky from Stanford saying that the variant may be a challenge. More concerning is the news from a friend of mine from Texas who says that two IT professionals who had both their shots in the US were visiting India to take care of their parents (infected with Covid). Unfortunately, the vaccinated IT professionals have died of Covid. He has promised to provide details as I have been skeptic of social media posts without backing. NPR also had a story yesterday that said 37 vaccinated doctors in Delhi have come down with Covid in New Delhi but did not say anything about their condition. As you already know that the daily caseload reported in India during the past 4-5 days has been ~200 to 300K and is probably closer to half a million or a million given the infrastructure and access to health. Even as early as last year I have suspected the numbers from India were being manipulated (see attached PDF) while looking at the Worldometer Covid update site. Sadly, I am speaking of the country I was born in and grew up- but cannot relate to or understand her values anymore. I was wondering if we are running the risk of another wave of infection in the US as hundreds (if not thousands) are flying between the US and India daily. I see that ~30% of the US population is fully vaccinated as of today and 43% have received a single shot -an enormous success by any rate in this short period. However, is it a risk, as we relax the guidelines in the US while allowing new variants enter and circulate in the community with more than half the population yet to be vaccinated? We have come this far and I really hope this sad episode does not repeat again. Sadly, there are folks within and outside our country who are waiting to use any opportunity to blame NIH/science and our president. I have lost sleep thinking of it since I saw the news circulating and thought that you or Dr. Fauci could provide an answer. I apologize for this long email. Sincerely, Sundar Sundar Venkatachalam, Ph.D. Chief, Preclinical Therapeutics Grants Branch Developmental Therapeutics Program Division of Cancer Treatment & Diagnosis National Cancer Institute sundarv@nih.gov BioNTech chief confident Covid jab will work on variant found in India VISIT TO BALTIMORE WITH VP HARRIS - Today I went to Baltimore at the invitation of Vice President Harris to accompany her to the M&T Bank stadium where the Baltimore Ravens football team plays. The stadium has served as a mega hub and mass vaccination site for the administration of vaccines in the city of Baltimore. It was a delightful trip strengthening my relationship with the vice president. She was her usual delightful self and as we walked through multiple sections of the indoor component of the stadium, we passed hundreds of people: people waiting to be vaccinated by the hundreds; people already vaccinated being observed; national guard who are helping with the vaccinations; and a wide array of sections of people vaccinating , entering information into a computer, and a pharmacy dispensing the vaccine. As we walked through the different sections people equally screamed out “we love you Doctor Fauci” and “we love you Vice President Harris. We stopped dozens of times to take selfies with a whole variety of people. The vice president was genuinely pleased to see the attention paid to me as well as to her. She is a real winner. PRESS: NBC interview with Heid Przybyla on the role of the VP in outreach to promote the uptake of vaccines; Italian TV La7 News; much press related to the visit to the VP to Baltimore. Joe Rogan walks back anti-vaccination Axios - comments April 30, 2021 - Global – 150,100,000/3,200,000; USA - 32,100,000/572,200 We shut down travel from India – See above. Travel from India will cease for all non-USA citizens. Will start on Tuesday May 4. I am concerned that by delaying the actual shutting down we will be faced with the same situation that we faced with China and the European Union. In those circumstances there was a rush of people trying to get to the United states who are noncitizens, and so a large number of people who were likely infected in fluxed to this country. • Senator Lindsey Graham has written 2 letters to me telling me that I must go to the border and see the seriousness of the situation since I am the chief medical advisor to the president. Obviously this is a political ploy to embarrass president Biden. I just wrote back to senator Graham and told him that my job is to develop vaccines and drugs and to be involved in strictly medical issues, and that the border problems are the CDC, the Department of Homeland Security, or the Department of State. PRESS: Interview with India Express (print); White House Press briefing (discussed 2nd shot); Canadian Broadcasting Company (CBC) – TV; Fireside Cat Online with Canadian Genomic Forum; WBUR (NPR) – “On Point” with Meghna Chakrabarti; Instgram with Eva Longoria; Local TV for Memphis, TN and New Orleans, LA; Institute), Torrian Baskerville of NASTAD, Edward Bitarakwate, Uganda Country Director for EGPAF, and Joyce Ouma of National Empowerment Network of PLWH in Kenya, and Maureen Goodenow of OAR Had usual Zoom meet with Sec Becerra. I informed him of Novovax results. Had SCIF meeting with Deputies regarding global distribution of vaccines PRESS: Andy Slavitt tweets a strong defense of me; Health Care Radio Interview June 15, 2021 – Global – 176,000,000/3,800,000; USA – 33,300,000/598,000 Cases continue to come: PRESS: NBC “The Tonight Show” with Jimmy Fallon June 16, 2021- Global – 176,000,000/3,800,000; USA – 33,300,000/600,000 Bob Redfield is out there spouting incorrect information saying that he feels strongly that this was a virus that leaked from a laboratory. The basis of his saying this is that he feels that the virus was so well adapted to humans right from the beginning that it had to have leaked from a lab. Any respectable virologist would know that this is total nonsense since the virus clearly could have jumped species as a less efficient spreader and causer of serious disease and had been circulating in the human population beneath the radar screen gathering efficiency in transmission and pathogenesis until it was finally recognized in the middle of December of 2019 when many people were getting seriously ill. This is the way viruses evolve from nature. In fact, we are still seeing that to this day in what we are currently experiencing in that variants are developing greater capability of spreading and gaining even greater pathogenesis. Another example of Bob Redfield being dead wrong. I am surprised and disappointed that he is out there spouting such nonsense. I guess that he wants to feel relevant now that he is no longer CDC Director. Email of support fro Michel Kazatchkine: From: Michel Kazatchkine <contact@michelkazatchkine.com> Date: Wednesday, June 16, 2021 at 9:54 AM To: "Lane, Cliff (NIH/NIAID) [E]" <clane@niaid.nih.gov> Subject: Tony Dear Cliff, Hope you are well. As many these days, I am looking forward very much to America being back in global / multilateral health! As many many people around the world, I feel deeply sorry and frustrated about the attacks on Tony. I know that his box is full. That is why I allowed myself to use your mail to convey him a message of friendship and support. Warm greetings Professor Michel Kazatchkine Special Advisor to the Joint United Nations Program on AIDS (UNAIDS) in Eastern Europe and Central Asia Senior Fellow, Global Health Center, the Graduate Institute of International and Development Studies, Geneva NEWS CLIPPING — USA TODAY — CONDENSED (1 SOURCE PAGE) “PRESS: CBS “This Morning”; ITV (UK TV); Interview with Alison Young of USA Today on lab-leak hypothesis; Interview with Yahoo Life; Did White House digital team PSA at NIH; New York Times Sway Podcast with…” Historical record of A.S. Fauci - Part 4

https://www.gocomics.com/lio/2020/05/13 June 5, 2020 https://www.gocomics.com/lio/2020/06/05 Nice article in Science by Jon Cohen: Anthony Fauci, loved and hated, plots his next move: ‘I'm not going to sit in my house’ In a candid exit interview, the NIAID head reflects on the seven presidents he served, controversial decisions, and feuding with Rand Paul • 1 Sep 2022 • 6:50 PM • By Jon Cohen PRESS: KNSD NBC (TV) + KUAN Telemundo, San Diego with Mark Mullen; 2021 Vaccines, variants, and controversy

Global – 151,800,000/3,200,000; USA – 32,200,000/573,800 • Had dinner over Jeff Zients’s house with wife Mary, Bob Seder and Deb Harman, Denis McDonough and wife Kari. Terrific time. Jeff is as wonderful on a personal basis as he is professionally. His home at 4500 Garfield Street, NW is absolutely magnificent. • Jeff Zients Called me this evening giving me a heads up that he might want me to write a one page memo the president Biden explaining to him the situation in India particularly with regard to the variants. I convinced him that it might be better to arrange for a phone call between me and the president so that I could respond to his questions rather than have him receive a memo that he would have questions about. Jeff said we could think about it overnight and decide tomorrow. PRESS: Connecticut Public Television “The Jane Whitney Show”

Global USA 2nd day in a row that numbers are way down – 19,500: We are having a serious problem here in that the Public Affairs people at HHS are refusing to allow Francis to put on the NIH website an explanation about what we did with the grant associated with the Wuhan laboratory. The HHS people are misguided thinking that by explaining the grant as well as what gain of function really means we will be calling attention to the issue. They completely fail to realize that there is already intense attention paid to this issue and the legitimate press including the Washington Post and the Atlantic are asking legitimate questions and wanting to know why we are not responding. We are going to put more pressure on HHS to allow us to be able to develop a statement for the NIH website as well as provide talking points and Qs and As. It is clear that the far right has stirred this up enough that now the legitimate press is beginning to ask questions. • Received this evening at the home (Villa Firenze) of the Italian Ambassador to the USA (Armando Varricchio) the Cavaliere di Gran Croce Ordino al Merito della Repubblica Italiana – Knight Grand Cross of Order of Merit of the Italian Republic conferred (in absentia) by Italian President Sergio Matarella We have a long and difficult conversation with the HHS people over the phone last night. Francis, Larry and I along with others on the NIH team discussed with the HHS team led by the new ASPA Sarah Lovenheim and Ian Sams among others. They were very reluctant to have us put a statement on the NIH director's website concerning the gain of function issue. This is completely ridiculous since if we do not respond to the many misleading statements that are being made then it will look like we're covering things up. The HHS people do not seem to understand that. They also are reluctant for us to directly answer letters of inquiry from the GOP members of Congress who are probing around the Wuhan issue. They are a new group and very inexperienced but they can really mess things up if we don't hold our ground. We finally got them to agree to put Francis's statement on the NIH webpage; however, they're still not allowing us to proactively put out the talking points and will only allow us to do that in specific answer to questions that come in. In another amazing aspect of the discussion they were actually claiming that we should not answer the letters that we get from Congress. More later on this struggle. PRESS: Good Morning America with George Stephanopoulos; White House Press conference (I spoke on variants and vaccines); Axios Online interview; NBC News Snapchat; multiple interviews at the Villa Firenze by the Italian press in association with my “Knighthood”.

Global – 169,600,000/3,500,000; USA – 33,100,000/591,400 Very few cases, probably as a result of holiday weekend: June 1, 2021 – Global – 170,400,000/3,500,000; USA – 33,100,000/591,500 A couple of interesting things today. Did the governor's call or I spoke about the possible need for boosters. In addition I had an interesting podcast with Chelsea Clinton . She is really a very nice person, much sweeter than I anticipated. Also had our usual weekly meeting with secretary Becerra. Also, we had an important meeting with the deputies in the SCIF to discuss the broad plans for the government’s response to COVID-19 including sharing vaccines with other nations. • I am absolutely furious today because the print version people of the National Geographic film group has published the list of my statements and words of wisdom in a book which they are claiming was written by me. It is listed in Amazon and Borders Books as a book “by” Anthony Fauci. This has triggered the usual frenzy from the far right crazies on social media saying that I am a hypocrite making a lot of money on the pandemic. Many of ask how much royalties I am making from the book. I have gone ballistic big demanding of the Nat Geo people that they correct this publicly and make it very clear that I did not write this book nor am I getting any royalties from it. When I allowed them to use my words from former speeches and commencement addresses, I assumed that they were going to use this merely as promotional material for the documentary. The fact that they made this into a book that they are selling in my mind isn't egregious violation of trust and collegiality. I am not going to cooperate at all in the promoting of this film. • In a Buzzfeed analysis of emails of mine that were FOIA’d, there is an email from me to Morgan Fairchild which clearly demonstrates that in February I was warning about the possibility of a global pandemic in contrast to what people are accusing me of, namely, saying that there was no risk to us. This is a very important email: PRESS: Jasmeen Abutaleb and Damien Paletta’s Washington Post article about my emails: https://www.washingtonpost.com/politics/interactive/2021/tony-fauciemails/?no_nav=true&tid=a_classic-iphone CNN with Elizabeth Cohen; Wisconsin NPR radio; June 2, 2021 – Global – 170,800,000/3,600,000; USA – 33,100,000/592,200 • I gave a taped speech today to the opening session of the G7 meeting taking place in England. I spoke about the similarities between the COVID-19 pandemic and the HIV aids pandemic. I called upon all partners to collaborate and to continue to support science. Secretary Becerra is representing the United states at the health component of the G7 meeting. Also, in line with my participation virtually in the G7 meeting , I took part in a discussion on the G7 global vaccine confidence summit. It was a discussion together with John Nkengasong, the director of the African CDC moderated by Vivienne Parry. We discussed the issue of vaccine hesitancy in various countries throughout the world particularly in the United states and in southern Africa. Nat Geo film people are also very upset about the shit storm caused by the book people and have come out with a statement that it is their book, not mine and I have not received any royalties or other payments from the book or the documentary. Unfortunately, the damage is already done. • Met with POTUS and VPOTUS in Oval with Jeff Zients and Natalie Quillian. I discussed with him the mechanisms and implications for the mRNA vaccine platform technology. He was very grateful for the discussion and as usual vice president Harris asked excellent questions. He told the story that when he was at Rehobeth beach in Delaware with his family, three burly MAGA-type men approached him and started trash talking him. The Secret Service were very discreet and did not want to make a scene; however his daughter Ashley jumped in front of them and started screaming at them to stay away from her father. The lesson of the story was that young women have more guts and fire then certain Secret Service agents. PRESS:The story on my emails is in the print version of the Washington Post this morning; Month of Action (promo video); Podcast with the George Bush Foundation – All the Best with Sam LeBlond; WGN Donilon Report (Leland Vittert) – was not the original person to interview me and attacked me about e-mails and Wuhan; NPRE “Science Friday” with Ira Flatow; Time Health Summit Interview by Alice Park with Stephjane Bancel; Time Children’s Interview; NBC Nightly News; MSNBC with Nicole Wallace; CNN defends me on the e-mails issue: Thousands of emails from and to Fauci during the pandemic's early days were published. Here's what they show about him By Christina Maxouris and Paul LeBlanc, CNN Updated 6:01 PM ET, Wed June 2, 2021 June 3, 2021 – Global – 171,300,000/3,700,000; USA – 33,100,000/592,800 Numbers continue to come down: • Writeups by CNN and Washington Post regarding my emails are making me look very good. They show that I never criticize president trump and that I am always very courteous and measured in my responses. Even with that the crazies such as senator Rand Paul are saying things like “I told you so “, implying that my emails are validating what they have been saying about me. Total nut cakes! The right-wing fringe social media are ablaze with anti-Fauci stuff • while all this is going on, incredibly the far right maniacs in certain states such as Arizona are trying to yet again force an unvalidated recount in an attempt to still overthrow the election and reinstate Trump. What is happening to our country ???? PRESS: CNN “New Day” with John Berman; MSNBC – Morning Joe; The alleged Fauci ‘smoking gun’ Washington Post: emails By Aaron Blake Senior reporter June 3, 2021 at 12:42 p.m. EDT In any case, like most data dumps that have careful redactions, the Fauci email trove has no smokinggun evidence of wrongdoing. You could make the case, as I and others have, that Fauci had certain prejudices and dispositions that were deeply unhelpful in his leadership of the pandemic response — and you’ll find evidence of those here. He had a very strong bias against existing drugs and for new and experimental ones. He has been slippery on masks and clearly was willing to say things in public that he thought “helped” the response even if they weren’t strictly true. Trump tears into Fauci after release of New York Post: early COVID emails By Mark Moore The Health 202: Five takeaways from Washington Post: Fauci's email exchanges By Paige Winfield Cunningham Reporter June 2, 2021 at 8:30 a.m. EDT with Alexandra Ellerbeck Early in the coronavirus pandemic, Anthony S. Fauci expressed skepticism that deaths in the United States would top 500,000. He called the public’s fascination with him “surrealistic.” And he assured China’s top public health official that “We will get through this together.” Hundreds of pages of emails obtained by The Post and BuzzFeed News through Freedom of Information Act requests confirm the way Fauci is already viewed by many — as diplomatic, tactful and responsive to inquiries from the public, a quality which often kept him up late at night answering emails. “The correspondence from March and April 2020 opens a window to Fauci’s world during some of the most frantic days of the crisis, when the longtime director of the National Institute of Allergy and Infectious Diseases was struggling to bring coherence to the Trump administration’s chaotic response to the virus and President Donald Trump was seeking to minimize its severity,” The Post's Damian Paletta and Yasmeen Abutaleb write. “Fauci’s actions during that period and beyond remain an intense focus for many Americans and political leaders,” they add. “During daily televised briefings at the White House, Fauci emerged as an at times reluctant — and polarizing — media star: To Trump supporters, he was a contrarian who seemed to undermine the president at every turn, while others viewed him as a reassuring voice of reason.” “The emails show that he was inundated with correspondence from colleagues, hospital administrators, foreign governments and random strangers — about 1,000 messages a day, he says at one point — writing to seek his advice, solicit his help or simply offer encouragement.” Here are five takeaways from Fauci’s emails. 1. Fauci stayed far away from any Trump-bashing. Trump blasted the public health expert throughout the pandemic, at one point threatening to fire him after the November election. And from time to time, Fauci would criticize the administration's response in interviews, although almost always indirectly (in October, he told The Post the country needed an “abrupt change” in public health behaviors). In Fauci's correspondence, he was even more circumspect. In April 2020, Marc Short, Vice President Mike Pence’s chief of staff, emailed Fauci about some apparent crossed wires before Easter Sunday. At the time, Trump was starting to butt heads with public health officials as he tried to move on from the pandemic. “You correctly noticed the symptoms but misdiagnosed the root cause,” Short wrote in a heavily redacted email that closes: “Apologies for a poor poker face.” Fauci responded: “Thanks for the note. Understood. I wish you a peaceful and enjoyable day with your family.” In another exchange, a former acquaintance wrote to Fauci that “The leadership from the top is utterly lacking and incompetent and dangerous to the American people.” “Thank you for your note,” Fauci wrote back. “I hear you!” 2. Fauci didn't like the public adoration. “Our society is really totally nuts,” Fauci wrote in an email he forwarded, which included the link to an article titled “'Cuomo Crush and Fauci Fever' — Sexualization of These Men Is a Real Thing on the Internet.” On March 31, a colleague at the National Institutes of Health sent Fauci an article from The Post with the headline, “Fauci socks, Fauci doughnuts, Fauci fan art: The coronavirus expert attracts a cult following.” “Truly surrealistic. Hopefully, this all stops soon,” Fauci replied. In another note, he added: “It is not at all pleasant, that is for sure.” 3. Fauci accepted a sort-of apology from the director of China's public health agency. George Gao, director of the Chinese Center for Disease Control and Prevention, had been quoted in Science magazine as saying the United States was making a “big mistake” by not telling people to wear masks in spring 2020. Gao, who has long been friends with Fauci, reached out personally to clarify his remarks. “I saw the Science interview, how could I say such a word ‘big mistake’ about others? That was journalist’s wording. Hope you understand,” Gao wrote to Fauci in a March 28 email. “Lets work together to get the virus out of the earth.” “I understand completely. No problem,” Fauci wrote back. “We will get through this together.” 4.Fauci defended himself to colleagues. In April 2020, prominent oncologist Ezekiel Emanuel wrote to Fauci that he was “perplexed” by his “seeming strong endorsement” of remdesivir. Fauci had publicly praised the antiviral drug, which had appeared effective in treating coronavirus patients. “Was it just a bit forced?” Emanuel wrote. “My reading was the data was weak and in normal times for normal disease it is not enough to approve. And very unlikely to really impact COVID-19 disease pattern- -regardless of supply issues.” Fauci resisted the characterization, replying that he didn't “'strongly' endorse it.” “I specifically said it was not a knockout drug and was only a baby step in the direction of developing more and better drugs,” Fauci wrote. “I said that it was important because it proved in a well-powered, randomized, placebo-controlled clinical trial that one can suppress the virus enough to see a clinical effect, as modest as the effect was. I do not think I forced anything.” In an email the following day, Emanuel sent another email apologizing to Fauci and inviting him over for dinner “on the porch.” In another email, Fauci pushed back against Gregg Gonsalves, a prominent Yale School of Public Health epidemiologist, after Gonsalves had appeared to insinuate that Trump was influencing him and other public health leaders. “Gregg: I am surprised you included me in your note,” Fauci wrote. “I genuflect to no one but science and always, always speak my mind when it comes to public health. I have consistently corrected misstatements by others and will continue to do so.” 5.Fauci corresponded with a wide array of people. He didn't just hear from administration and public health officials. The emails also show exchanges with members of Congress and regular citizens. Fauci certainly didn't answer every single email he received, but the tranche shows he made an effort to respond amid the many demands on his time. “The medical director of the National Football League Players Association asked Fauci for a confidential briefing on how to safely start the next NFL season,” Damian and Yasmeen write. “A documentary filmmaker working on a forthcoming Disney-backed biopic asked to ride along as Fauci drove to work. An adviser to Microsoft co-founder Bill Gates expressed concern about Fauci’s health. And a senior House Republican told Fauci to ‘keep being a science truth teller’ despite skepticism about the virus from other GOP lawmakers and Trump himself.” “I was getting every single kind of question, mostly people who were a little bit confused about the mixed messages that were coming out of the White House and wanted to know what’s the real scoop,” Fauci said in a recent interview. “I have a reputation that I respond to people when they ask for help, even if it takes a long time. And it’s very time consuming, but I do” respond. Thousands of emails from and to Fauci during the pandemic's early days were published. Here's what they show about him While many federal government staffers prefer the phone to email, this correspondence offers a rare glimpse into Fauci's frantic schedule and polite, to-the-point demeanor during the time he emerged as a rare source of frank honesty within the Trump administration's Covid-19 task force. But they also reveal the weight that came with the role. By Christina Maxouris and Paul LeBlanc, CNN June 4, 2021 – Global 171,800,000/3,700,000; USA – 33,100,000/593,400 • I had my usual every two-week meeting with my English colleagues doctor Chris Whitty and Patrick Valance. The discussion was somewhat disturbing since they seem to be having 2 issues simultaneously in the UK. They were controlling the B.117 variants very well and were preparing to open up. however, the B.1. 617variant appears to be much more effective in transmitting than the B.117. and so they are experiencing a surge of the B 617. They were planning to open up the country , but now they are having second thoughts since they are afraid that the new variant will create a second major surge for them. I will bring this up to our own medical team since we do have a low level of B.1.617 in our own country and if a certain proportion of people (mostly in the red states )do not get vaccinated, we may be faced with the same problem that the Brits are facing. • The onslaught against me but the radical right continues. The right wing press is intensifying their attacks on me as well as the right wing congressman and senators. some of the valid press such as the Washington Post , the LA Times , and others are calling out the lies of the far right. POTUS defends me: Kyle Griffin @kylegriffin1 Pool report: Biden left the room to a shouted question regarding whether he has confidence in Dr. Fauci. Suddenly, POTUS's head peeked around the corner, and he answered: "Yes I'm very confident in Dr. Fauci." 6/4/21, 11:30 AM • I did a kickoff event for the month of action – “We can do this”. I did it together with congressman Cedric Richmond who is director of the office of public engagement. We address the people who will be the trusted messengers going out into the community to try and encourage people to get vaccinated. Very important and very strange briefing of me by the CIA in the NIH SCIF this afternoon (5:00 PM). I received an extremely strange an unexpected briefing today by the CIA related to the origin of the virus. Beth Cameron from NSC was listening in on one of the other screens. And as it turns out she was as baffled as I was by the briefing. It was very similar to some of the very disappointing briefings that I had previously received in prior years from the CIA. A young woman whose name was Camille Hartman gave most of the briefing. She was accompanied by what was probably the senior male CIA person and another young woman. Camille in my mind was almost pathetic in her naivety an obvious lack of appreciation of any of the science of what she was talking about. She gave instances of things that she said were gotten by CIA intercepts of conversations in China, particularly in Wuhan. her major point was that she feels but the Chinese have not been transparent about what was going on in their labs since there were no reports publicly of what they found out from intercepts. This included the transfer of Pangolin viruses from a group in Beijing two Wu Han. They felt that this was being used in a study using transgenic mice. I have no idea why this was any great concern to them since it would be perfectly natural for a lab that studies coronavirus to look at Pangolins. In addition, she spoke about the observation that WIV was sampling Pangolins and several members of WIV took a trip to obtain Pangolins. They also spoke about the fact that they have information from sources that unknown experiments well conducted by the military in Wu Han. The thing that blew me away about how naive and uninformed they are was the fact that they mentioned that they had word that in July of 2020 there was a super spreading event in China related to passage of virus in the laboratory. This astounded Beth and I for the same reason. Why would they suspect that a super spreading event that occur in the middle of a major outbreak in China was related to the passage of virus in the laboratory? The naivete of the briefing stunned both Beth and me. Also, in the matter in which she was asking me questions almost made me believe she was grilling me prompting me to say somewhat tongue in cheek whether I should have a lawyer with me. I got on the phone with Beth immediately after the briefing and she was very upset saying that she was going to check up the chain who and why this briefing was called and why there was no forwarding material to prepare us for what they were doing. There is something very fishy about all of this. PRESS: BBC Radio; White House regional press (3 stations); Mediaite: Chris Wallace Defends Fauci From ‘Highly Political’ Attacks: His Lab Leak Emails Contain ‘No Smoking Gun’ https://bit.ly/3ciVYik June 5, 2021 Global – 172,200,000/3,700,000; USA – 33,200,000/594.,000 40th anniversary of the first cases of AIDS reported in MMWR - a lot of appropriate attention is being paid to the 40th anniversary. There were several articles in the press recounting the early days and focusing on my role . I did a number of print and TV and radio interviews. The attacks on me continue to ramp up. Trump planning on blasting me during his speech tonight at a Republican party gathering. Caught in crosshairs, Fauci calls GOP PRESS: descriptions of his emails 'profoundly misleading' By Michael Warren, Kaitlan Collins, Gabby Orr and Daniella Diaz, CNN June 6, 2021 - Global - USA Today I fly up to New York City with first lady doctor Jill Biden to promote vaccinations among the African American community. We will be visiting the Abyssinian church in Harlem. The vicious assault on me continues . Most recently House Minority Leader Kevin McCarthy has called for me to be fired. What an amazing coward he is. The entire extreme right wing republican group in the House and Senate have completely sold their soul to the infinitely lying ex president trump. • I spoke with Jeff Zients this morning and he told me that Ron Klain told him that President Biden is 100% behind me (see above). June 7, 2021 – Global – 173,000,000/3,700,000; USA – 33,200,000/594,800 • Eventful day - I went to New York today with first lady doctor Jill Biden for two reasons: 1st )to visit the Abyssinian Baptist Church in Harlem in order to thank them for setting up a vaccine clinic and to encourage them to continue to advocate for young people to get vaccinated. I flew up with the first lady on one of the Air Force planes assigned to the White House and had a great conversation with her on the plane up as well as on the plane down. She is an amazingly natural and one person with whom I believe we have now started a good friendship. The people at the Abyssinian church or extremely kind to me in saying how much they appreciated that I was there and all of them wanting to take selfies with me. We stayed at the Bowery hotel at the interface between Chinatown and the Bowery. i was surprised that we picked the hotel Since where we want to go for the TV hit the following morning was way Uptown. Brett Rowland and I had a great Italian dinner at the Primi restaurant in the Bowery. The following day the first lady and I appeared together on the Kelly Ripa and Ryan Seacrest Show (KABC). It was very lighthearted and enjoyable. Another very important aspect of the day is that as I was getting ready to take off with the motorcade from the White House on the way to Andrews Air Force Base, the president came walking down the back alley , the Secret Service called me out of the car , and the president put both his hands on both my shoulders and said “I just want to tell you that I am behind you 1000%”; and he repeated again “I am behind you 1000%.” He said “those people are crazy they have no idea what they're talking about and just don't pay any attention to them.” • Back to the dark side. Scott Gottlieb had appeared on Face the Nation and mentioned in an attempt to help me then I had actually gone to Europe in Jan/Feb. 2020 to brief health ministers about the possibility that the virus could have been constructed an escape from the laboratory. He did this to indicate that I was not hiding anything because I already knew that this was a possibility and so I didn't change my mind currently by saying that a lab leak is a possibility since I was talking about it openly back then. As it turns out, he was a little bit mixed up because on January 31st, 2020 I received a call from Jeremy Farrar who conferenced in Christian Andersen to tell me that Ed Holmes and Christian had seen a copy of the sequence of the virus and felt that there was a possibility that because of the unusual furin cleavage site that this could possibly have been a constructed virus. as indicated in my notes of January 31st and February 1st , 2020, since I am not an evolutionary biologist I called together by phone a group knowledgeable scientist together with Francis Collins and a few other people to discuss this. After a considerable amount of discussion about half of the people felt that this was possibly a constructed virus and the other half were convinced that this was a natural occurrence. A few weeks later Christian Andersen got together with Bob Garry and Andrew Rambaut to examine this more carefully and they came to the conclusion that they were convinced that this. was a natural occurrence and a jump from the animal reservoir. They published their data in a preprint server in February followed by a nature paper in March of 2020 . That is the reason why it appears that a I briefed people which I did not . I was briefed by them . Scott had said that I had briefed a group of international health people he seemed to have gotten some of the story wrong , but overall he was correct. Cases continue to come down: June 8, 2021 – Global – 173,3000,000/3,700,000; USA – 33,200,000/595,300 NEWS CLIPPING — THE PRESS — CONDENSED (1 SOURCE PAGE) “Cases continue to come down: Far right still slamming away. It is very clear that this is a well-organized effort. PRESS: Interview with Dutch newspaper NRC Handelsbad – Bas Blokker interviewer; Smithsonian Channel TV Documentary…” Column: The Terrific article in the LA Times strongly defending me: right’s attack on Fauci shows it has nothing in its policy tank but slogans By MICHAEL HILTZIK BUSINESS COLUMNIST JUNE 8, 2021 5 AM PT Another great article in the Miami Herald defending me: Despite Trump’s new round of bullying, Fauci says COVID likely didn’t leak from a Chinese lab | Opinion BY ANDRES OPPENHEIMER JUNE 08, 2021 09:13 AM, UPDATED 19 MINUTES AGO LA TIMES – MICHAEL HILTZIK: Column: A Nobel laureate backs off from claiming a ‘smoking gun’ for the COVID-19 lableak theory June 9, 2021 – Global – 173,700,000/3,700,000; USA – 33,200,000/595,600 Today the president went to England on the first leg of the trip involving the G7 summit. With regard to COVID-19, he has a very important message to deliver which I am very pleased about. He will announce that the United States will give away 500 million doses of the Pfizer vaccine to countries that do not have the capability of getting their own vaccine. I have been pushing for this for some time with Jeff and I have even spoken to the President and VP about the need to take a leadership role in getting vaccines to the lower and middle income countries. This is a first step towards vaccinating the world and to having the United States resume our leadership role throughout the world. I will continue to push to have technology transfer to the developing world so that ultimately they may be able to make their own vaccine. But for now, the role of the United states as a world leader has been clearly affirmed by the President's action PRESS: CNN with Erika Hill; Podcast with former Congressman Pete Sessions; MSNBC “Meet the Press Daily” with Chuck Todd; Wall Street Journal Tech Summit; My picture was on the 1st page of the Style Section of the Washington Post together with Jill Biden and Debra Frazier-Howse Washington Post: Biden administration to buy 500 million Pfizer coronavirus vaccine doses to donate to the world By Tyler Pager and Emily Rauhala June 10, 2021 – Global – 174,000,000/3,800,000; USA – 33,200,000/596,000 Cases still low: • I had a really nice conversation with Chuck Todd this morning. He had texted me to ask what I thought of the interview yesterday. I told him that I thought it was absolutely terrific, but I wanted some advice from him . I asked him whether he thought that I should pull back from publicly defending myself against the slanderous attacks since that might call more attention to them. He completely agreed and said that Fox News and people like Tucker Carlson would use anything I say as the theme for their next show. Chuck is really an excellent journalist and although he must maintain his objectivity and reporting it is very clear that he is really being a friend in understanding the difficult position that I am in. • Did Fireside chats with Irini Sereti; Bio Annual Meeting Fireside chat with Julie Gerbelding; “Reaching adolescents” interview with Vivek Murthy Only in our PRESS: Univision Interview with Ilia Calderone; Washington Post - anti-truth hellscape could Anthony Fauci become a supervillain Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, listens during a Senate hearing last month. (Stefani Reynolds/Pool/AP) By Margaret Sullivan Media columnist June 10, 2021 at 7:00 a.m. EDT June 11, 2021 – Global – 174,500,000/3,800,000; USA – 33,300,000/597,000 Press are beginning to push back and point out how ridiculous the criticism of me is (see below in Vanity Fair) • Did multiple outreach chats today with mayor Muriel Bowser, with the college challenge event and with two White House arranged interactions with young “influencers “ • Also have a zoom meeting with David Kessler , Peter Staley, and James Krellenstein. Peter and James have been pushing to have the United States government make a major investment in Lanza, which is the company that produces the doses for Moderna. David explained to them that there is enormous capacity with the mRNA companies themselves and so was not particularly amenable to going straight to Lanza. I have been trying to broker an understanding between Peter and James and David , but I'm not so sure how successful I would be • . The data were extremely exciting with a 90.4% vaccine efficacy and 100% efficacy against severe disease. We are becoming almost complacent with these spectacular results about vaccine efficacy . However, this result will add an important component to our armamentarium PRESS: NDTV New Delhi, India; Republicans Are One Week Away From Demanding Anthony Fauci Be Deported to Wuhan Conservatives are obsessed with the baseless idea that the veteran immunologist had something to do with COVID-19’s origins. By Bess Levin June 12, 2021 – Global USA • had our usual medical team meeting with Jeff this AM (Sat). The important good news is that the president's announcement a 500 million doses of vaccine going to low and middle income countries is going across very well throughout the world. As the president has said, “America is back “ in our rightful leadership role. • Had a very good conversation today with Hugo Crosthwaite and Taina Caragol. Hugo is a famous artist who will be doing a commissioned “motion” portrait of me for the National Portrait Gallery. Taina works for the NPG. The theme of the portrait is the show that I have been the symbol of truth and science and have been attacked by the forces of untruth and evil. His prior work is in an unusual medium where he those pencil drawings of a person Anne photographs them to look like a mini movie picture. I have seen some of his work and it is extraordinary and spectacular. I am looking forward to seeing what the result will be. The results should be sometime at the end of the year. No, Fauci is not profiting from a PRESS: New York Times (Davey Alba) - coming book on lessons he’s learned from his public service. The above article points out the fact that despite Nat Geo making it very clear that I received no money from their book the far right including many GOP congressman I still insisting that I was profiting while people were dying. The extraordinary crazyness continues. June 17, 2021 – Global USA Participated in Faith Vaccine Roundtable – young Muslim messengers PRESS: NPR “Morning Edition” with Leila Fadel; did the White House Press Conference – I announced the new $3.2 billion Antiviral Program for Pandemics, which a 2 pillar program for Development and Discovery of antivirals for COVID-19 and other viruses of pandemic potential; Great Article in Politico that describes the lies of the Trump people about the “lab leak” theory: Top Trump officials pushed the Covid-19 lab-leak theory. Investigators had doubts. New documents and interviews show how the president and his senior aides cherry-picked evidence and sidelined the government’s own virus sleuths. NEWS CLIPPING — POLITICO — CONDENSED (3 SOURCE PAGES) “A Northwell Health lab technician uses the Abbott ID NOW Covid-19 rapid tester on a participant before a news conference on April 14, 2021, in Elmont , N.Y. | Mary Altaffer, Pool/AP Photo By ERIN…” 2016. And Trump wasn’t invited to speak at the grandfather’s funeral as presidents traditionally do. If George P. Bush’s name had been George P. Jones, his political rise undoubtedly would have been less smooth. But now he’s shocking a lot of Bush family admirers in his quest to receive a pat on the head from Trump — or at least not a swat. Sure, a lot of Texas Republican primary voters worship Trump, but is winning a nomination for state office worth losing one’s honor? It’s a guarantee that Fauci would not kiss the rear end of anyone who insulted his family. What we have here is a short guy from Brooklyn basically brushing off Trump’s menacing antics while swaggering Texas Republicans collapse at the sign of a New Yorker’s displeasure. And there’s one other reason for Trump’s continued obsession with Fauci: envy. Trump is fading from national prominence. Even Fox News no longer carries all his speeches live. But Fauci goes on. He’s still respected by the sort of people whose respect serious leaders want. His polls numbers remain high. As the virus threat recedes, not every pronouncement Fauci makes will grab headlines, but he’s not there for that. He’s there to do the science. The rightwing attacks on him can’t be pleasant, but Fauci will end his long career with a legacy of public service and, importantly, his dignity intact. June 18, 2021 – Global – 177,000,000/3,800,000; USA – 33,300,000/600,000 Received important e-mail with attachment from Jesse Bloom: Hi Francis, Stephen, and Toni, I’m just writing to give you a heads up that I identified a data set of early Wuhan SARS-CoV-2 sequences that has been deleted from the NIH’s Sequence Read Archive (SRA). I was able to recover the deleted files from the Google Cloud and analyze the sequences, and have attached a pre-print on the analysis that I just submitted for posting by bioRxiv. Since SARS-CoV-2 origins and early spread has become a hot-button topic, I wanted to give you a heads up. I made sure to emphasize in the discussion that the SRA has many sequences and so isn’t in a position to vet all deletions. Nonetheless, I think it would be highly worthwhile to do a comprehensive analysis of SRA (and other NIH) data that might be relevant to this topic that could have been deleted or otherwise overlooked. If I can be of any assistance, let me know. I have been running a pipeline to identify additional deleted SRA data using various heuristics including those in described in the attached pre-print, but have not yet completed the analysis enough to know the extent that the data I have recovered is relevant to SARS-CoV-2’s origins or early spread. But as I mention in the pre-print, there are two known SRR deletions that are worth looking at. I definitely think it would be good to perform a SRA side search as well, since that will obviously be easier and more efficient, and could identify deleted data not on the cloud. Anyway, I hope overall this can be a good opportunity for the NIH to take the lead by using its remarkable data archives to make progress in resolving some of the important questions about the virus’s origins. Thanks, Jesse ---- Jesse Bloom Associate Professor, Fred Hutch Cancer Research Center Affiliate Associate Professor, Genome Sciences & Microbiology, University of Washington Investigator, Howard Hughes Medical Institute paper.pdf I believe that it was somewhat imprudent on the part of Jesse bloom to make statements such as he has that indicate nefarious motives on the part of the Chinese when we have no idea why they deleted the sequences. He used words such as “obscure” and “surreptitious” which will certainly create a firestorm when conspiracy theorists read it. The best thing to do is to have Frances and I again convene a group of evolutionary virologists to discuss the potential meaning of this . We will do this two days from now on Sunday June 20. See below. Cases at around 12,000 per day NIH helped fund research involving donated fetal tissue, but Fauci was not directly involved PRESS: Excellent refutation of the lab leak hypothesis in The Guardian: Though it is newly respectable, the Wuhan lab theory remains fanciful David Robert Grimes June 19, 2021 - Global USA Horrible roller coaster day – Due to some acute transient right posterior chest pain 2 days ago, Ted Li order a CT scan. - I got a call from the radiologist at Sibley hospital where I had gotten a chest CT in the morning telling me that I had a lesion in my right lower lobe that he felt was a cancer (non-small cell carcinoma). I felt like I got hit like by a Mack truck. Doctor Li quickly followed up on this and show the film to Andrew Lerner at Sibley who is a pulmonologist specializing in pulmonary nodules. Doctor Lerner felt that it was more likely an inflammatory lesion and there were multiple other lesions that were very small throughout the right lower lobe. In addition, I had a pulmonary infarct in the right lowest segment that was definite. Again, Dr. Li called David Hellmann Who was with his son who is an oncologist who looked at it and said that it looks more benign then neoplastic and felt that it did not look like a non-small cell carcinoma. Finally, they showed the films via computer to Dr. Elliot Fishman who is the top radiologist at Hopkins. He agreed that it was more likely inflammatory and that the only definite thing on the film was the pulmonary infarct. He recommended a follow-up CT in three months and begin anticoagulation immediately with Eliquis. Chris and I viewed the “FAUCI” documentary doe by Nat/Geo together with the leadership of Nat/Geo films at the national geographic headquarters on 17th Street, NW. Very impressive film. At the request of the White House I did a walking tour of the Anacostia neighborhood Of Washington DC together with Mayor Muriel Bowser. we started off at anacostia high school where we thanked the volunteers in the basketball gym who were administering vaccines to people in the neighborhood . We then went on and addressed the volunteers in the schoolyard of Kramer Middle School. After that, the mayor and I went door to door knocking on the doors and encouraging people in the neighborhood to get vaccinated. We did that for about an hour and 15 minutes. it got written up the next day in the Washington Post (see below). PRESS: Washington Post: “For Ward 8 residents, coronavirus vaccine appeal comes with a touch of celebrity: ‘It’s Fauci!” https://wapo.st/3vFzhLZ June 20, 2021 – Global USA Uneventful and somewhat relaxing day . Still trying to process the news from yesterday. Will have to live with uncertainty for the next three months. As indicated above, Francis Collins organized a zoom call for today with a group of evolutionary biologists as well as Steve Sherry from the NIH databank in order to discuss this issue. Jesse bloom was also on the call. See email below from Francis having organized the meeting: From: Collins, Francis (NIH/OD) [E] <collinsf@od.nih.gov> Sent: Sunday, June 20, 2021 2:33 PM To: Tabak, Lawrence (NIH/OD) [E] <lawrence.tabak@nih.gov>; Fauci, Anthony (NIH/NIAID) [E] <afauci@niaid.nih.gov>; Embry, Alan (NIH/NIAID) [E] <embrya@niaid.nih.gov>; Sherry, Steve (NIH/NLM/NCBI) [E] <sherry@ncbi.nlm.nih.gov> Cc: Kristian G. Andersen <kga1978@gmail.com>; Bedford, Trevor <tbedford@fredhutch.org>; Bloom PhD, Jesse D <jbloom@fredhutch.org>; Garry, Robert F <rfgarry@TULANE.EDU>; rasmus_nielsen@berkeley.edu; spond@temple.edu Subject: RE: URGENT: Seeking your expert advice Allow me to suggest this agenda: 1) Introductions 2) Retrieval of SARS-CoV-2 reads deleted from SRA by submitter – Jesse Bloom 3) NCBI SOPs for handling submitter requests to delete reads in SRA – Steve Sherry 4) Likelihood of other sequence deletions from SRA? – Steve Sherry 5) Significance of this new sequence information for origin of SARS-CoV-2 – Jesse, Kristian, Trevor, Bob, Rasmus, Sergei 6) Discussion and next steps – All Looking forward to the discussion. Francis Please see the people copied on the above email for a list of those who were present at the zoom call. The only person on the list who was not there was Trevor Bedford who could not make the zoom connection. After considerable discussion among the group, it became clear that Jesse Bloom had really jumped the gun and made assumptions that the Chinese were surreptitiously hiding sequences by deleting them. Several of the scientists including Sergei Pond and Rasmus Nielsen felt that the sequences that were deleted and ultimately recovered partially were not of any particular consequence in shedding any light on the origin of SARS Co V2. The entire group felt that this was an inappropriate move on the part of Jesse to publish a single author paper making serious innuendos without running it by anyone else. As it turns out after discussion with Steve Sherry who is in charge of the NIH Sequence Read Archive (SRA) from which the sequences were deleted, it became clear that this is not an unusual occurrence for scientists to delete sequences if they are found to be either inaccurate , not up to date, or listed on another databank. He went back and looked at the required email to have the Wuhan sequences deleted, and the Chinese had indicated that they were removing it because they were putting it on their own separate database. According to Steve this would be a perfectly valid reason to remove a sequence. This obviously is going to cause us a lot of difficulty since those who feel that the Chinese are trying to cover up a lab leak will certainly say that this deletion of sequences proves that that is the case. It is really a shame that Jesse acted really in my opinion somewhat immaturely in making inflammatory statements in a preprint without further investigating the reasons behind the deletions. The NIH came out with the following statement in response to press inquiries regarding the Bloom preprint: NIH is aware of Dr. Bloom’s preprint submission. Staff at the National Library of Medicine, which hosts the Sequence Read Archive (SRA), have reviewed the submitting investigator’s request to withdraw the data. These SARS-CoV-2 sequences were submitted for posting in SRA in March 2020 and subsequently requested to be withdrawn by the submitting investigator in June 2020. The requestor indicated the sequence information had been updated, was being submitted to another database, and wanted the data removed from SRA to avoid version control issues. The submitting investigator published relevant information about these sequences by preprint in March, 2020 and in a journal in June, 2020. Submitting investigators hold the rights to their data and can request withdrawal of the data. Currently, the National Library of Medicine (NLM) has no plans to change the policy that recognizes submitters rights to their own data and the right to petition that their data be withdrawn from the Sequence Read Archive (SRA). The National Center for Biotechnology Information (NCBI), part of the NLM that manages the database, is the U.S. participating member of the International Nucleotide Sequence Database Collaboration, which provides guidelines for withdrawing data: http://www.insdc.org/documents/insdc-status-document. NLM/NCBI can’t speculate on motive beyond a submitter’s stated intentions. June 21, 2021 – Global -178,000,000/3,900,000; USA – 33,400,000/600,000 Did an Instagam live with FGOTUS Doug Emhoff and Dikembe Mutombo to encourage people to get vaccinated. We are putting a full-court press in encouraging people to get vaccinated. Did TIKTOK interviews (rapid fire questions) from 8 young TIKTOK “influencers who amazingly have millions of followers FOX News is blasting me for saying that an attack on md is an attack on science. I am going to go on the offensive against them. To me, it is a badge of honor to be criticized by FOX. Important article in the Post today by Joel Achenbach (see below) PRESS: NY Times by Carl Zimmer and James Gorman: Fight Over Covid’s Origins Renews Debate on Risks of Lab Work Excerpt from above NY Times article: NEWS CLIPPING — WASHINGTON POST — CONDENSED (2 SOURCE PAGES) ““When questioning Dr. Fauci last month, Senator Paul brought up one of the most cited examples of gain-of-function research, a study of coronaviruses done by Ralph Baric at the University of North Carolina published in…” Health Scientists battle over the ultimate origin story: Where did the coronavirus come from? By Joel Achenbach June 20, 2021 at 5:58 p.m. EDT June 22, 2021 – Global USA Had podcast with the Conference of Mayors Vaccinations coming along very well: PRESS: BBCTV with Katty Kay; CNN “The Lead” with Jake Tapper; MSNBC “All In” with Chris Hayes Very good interview on New York Times “Sway” with Cara Swisher: NYT/Sway: Anthony Fauci on the Lab Leak Theory and Emailing Mark Zuckerberg https://nyti.ms/2UfIr4K The Hill: Poll: 61 percent say Fauci has been truthful to the best of his knowledge on COVID19 origins; NPR Radio – 1A; The New Yorker: Anthony Fauci, Lifeguard The doctor is in, no matter what time of year. By Barry Blitt June 24, 2021 – Global – 179,000,000/3,900,000; USA – 33,400,000/600,000 I had another terrific day with First Lady Dr. Jill Biden. We flew to Florida from Andrews with all the bells and whistles of motorcades to visit two cities: Osceola County near Orlando and Tampa Bay. We have become somewhat of a good team together in visiting with the sites that were administering the vaccine, mingling with both the people who are being vaccinated as well as the staff who were doing the vaccinating. At each stop both doctor Biden and I made remarks and spoke with the press. Of particular note was the visit to Tampa Bay where we met with Mr. Jeff Vinik, the owner of the Tampa Bay Lightning , the hockey team that would be playing the 7th game of the semifinals for the Stanley Cup finals the following day. They gave both Jill and I our own jerseys with our names on them. We gave our speech on the ice of the arena where the Tampa Bay Lightning plays. I am getting to be quite good friends with Jill and I think that our relationship will strengthen as we continue working together. June 23, 2021 – Global – 179,000,000/3,900,000; USA – 33,400,000/600,000 Did an Instagram with Jennifer Garner on vaccines. She was wonderful as she was last time. We spoke of the vaccination of her 3 children. Cong. Stephen Scalise wants to hold a panel on the originals that would be a “set-up” to attack Francis Collins and me: 2021.06.22 Fauci Invite.pdf Here is the announcement of the “set-up” hearing. We would be crazy to honor it. The Panel 1 are a bunch of wackos: Select Subcommittee Republicans Announce Expert Witness Forum on COVID-19 Origins Forum to be held with expert witnesses on Tuesday, June 29 WASHINGTON—On Tuesday, June 29 at 12:00 p.m. ET, Republican Whip and Select Subcommittee on the Coronavirus Crisis Ranking Member Steve Scalise (R-La.), House Committee on Oversight and Reform Ranking Member James Comer (R-Ky.), and Select Subcommittee Republican lawmakers will hold a forum with expert witnesses to examine the origins of the coronavirus. For more than a year now, Republicans have repeatedly called on Democrats to investigate the mounting evidence showing the virus originated from the Wuhan Institute of Virology (WIV) lab, but Democrats continue refusing to launch an investigation. “The left-wing media called it a ‘fringe conspiracy theory,’ Big Tech censored it, activists in white lab coats dismissed it and Democrats ignored it, but there is growing evidence Communist China started the pandemic, covered it up, and is responsible for the deaths of more than 600,000 Americans and millions more worldwide,” said Scalise and Comer. “Despite Speaker Pelosi’s efforts to create diversions and cover this up, the American people deserve the truth and are demanding accountability, and House Republicans will insist on getting these answers. “The House Democrat majority’s refusal to follow the science, listen to the experts, and investigate the origins of COVID-19 is a dereliction of their duty. Next week, Select Subcommittee Republicans will hold a forum with expert witnesses to advance our investigation into the origins of COVID-19,” added Scalise and Comer. “The American people deserve to know the truth, even if Washington Democrats refuse to seek it.” It was recently reported that three researchers from the Wuhan lab became ill with symptoms consistent with COVID-19 and sought hospital care in November 2019. Additionally, Dr. Fauci’s recently released emails from February 2020 reveal that scientists raised the possibility of a lab leak and also expressed concern the virus appeared to be engineered. WHAT: Select Subcommittee expert forum entitled “Led By Science: The COVID-19 Origin Story” WHEN: Tuesday, June 29 at 12:00 p.m. ET WHERE: HVC-215, Capitol Visitors Center WHO: Witness Panel I The Honorable Brett P. Giroir, former Assistant Secretary for Health, U.S. Department of Health and Human Services: Admiral Giroir brings firsthand knowledge about the public health response to the COVID-19 pandemic. As COVID-19 testing czar, he oversaw creating a nationwide testing apparatus from scratch which was made particularly difficult by China’s lack of transparency. Admiral Giroir will also discuss the investigatory failures of the World Health Organization and why a U.S.-led origins investigation is vital. Dr. David Asher, Senior Fellow, Hudson Institute: Dr. Asher has decades of national security experience and most recently led the U.S. Department of State’s COVID-19 origins investigation. His testimony will provide inside information into the origins investigation and the role of the Chinese government’s efforts to block a thorough and impartial investigation. Dr. Richard Muller, Emeritus Professor of Physics, University of California Berkeley: Dr. Muller is an acclaimed scientist that used his own research to study available data in attempting to determine the origins of COVID-19. He recently penned an op-ed in the Wall Street Journal pointing out there is strong evidence COVID-19 was developed in a laboratory using gain-offunction acceleration. Dr. Steven Quay, Founder, Atossa Therapeutics: Dr. Quay is one of a growing number of scientists dedicated to finding the origins of COVID-19. He has conducted his own research using the publicly available viral data and reached conclusions apart from outside influence. He brings significant scientific expertise to this endeavor including over 87 patents and hundreds of published scientific articles. Member Panel The Honorable Cathy McMorris Rodgers, Member of Congress The Honorable Michael McCaul, Member of Congress The Honorable Devin Nunes, Member of Congress The Honorable Mike Gallagher, Member of Congress Witness Panel II (invited but hasn’t yet accepted) The Honorable Francis Collins, Director, National Institutes of Health Dr. Anthony Fauci, Director, National Institute of Allergy and Infectious Diseases Dr. David Hassell, Chairman, P3CO WATCH: A livestream will be available HERE. PRESS: WSJ: Dr. Fauci and the Mask Disaster; CBS “This Morning” with Anthony Mason; NBC “Today” with Savannah Guthrie; Month of Action interviews with influencers on TikTok and Instagram (one with Jennifer Garner) June 24, 2021 – Had a great day with FLOTUS Dr. Jill Biden - I flew on one of the presidential planes with Dr. Jill Biden, assembling at the White House for the motorcade to Andrews Air Force Base. Brett Rowland came with me. We went to Florida for a two city stop to promote vaccines. The first stop was at Osceola County near Orlando. The next stop was at Tampa Bay where we did a vaccine promotion event right on the ice in the arena that is used by the Tampa Bay Lightning team. Of note, tomorrow the team plays the 7th game of a seven game semifinal before the Stanley Cup finals . They will be playing the New York Islanders. We had a nice conversation with Jeff Vinik and his family. Jeff is the owner of the hockey team and he gave me a team jersey with my name on it as well as a team jersey to Jill with her name on it. It was a very productive day as both Jill and I gave speeches at each of the locations and encourage the workers there and the people lined up to get vaccinated. No doubt Jill and I are now developing a very strong relationship, as we really have developed a comfortable and warm rapport with each other. June 25, 2021 - Global – 180,000,000/3,900,000; USA – 33,400,000/601,000 I did something this morning that I feel very good about. I went over to the clinical center and participated in the “graduation ceremony” of the people in project search who are a group of handicapped individuals who underwent a training program here at NIH and were then given jobs here. I did selfies with each and every one of them, took a group photo, and gave them a pep talk about why their work is so important. I have such empathy for people who through no fault of their own were dealt a difficult hand in life. As a bit of background, Mayor Bill Di Blasio of New York City had invited me to be the Grand Marshal of the parade of heroes for the 4th of July weekend in New York City . It would be similar to the ticket tape parades that honored returning war generals. The purpose of the parade was to honor health care workers and first responders to the outbreak in New York City period, and since I am a well-known New Yorker, he wanted to make me the Grand Marshall of the parade. I did not think that this would be appropriate since we have not yet controlled the outbreak and since those people (far right radical GOP) who have been attacking me viciously over the last several weeks would probably have a field day if I did that , I decided that I would express my gratitude for the invitation but would decline. On my way in the motorcade between airports in Florida yesterday (Friday) Bill called me up on my cell phone to see what my decision was about the invitation. I explained to him my reason for declining, and thankfully he was extremely gracious and understood . He promised me that he would get another chance to honor me for what I have done for New York City and for the country. Had meeting in my office with Dr. Jeff Lehman, former president of Cornell University and now current American President and Vice Chancellor of NYU in Shanghai. Jeff has been in Shanghai for the last nine years and has considerable insight into the Chinese culture. He asked to visit me to explain to me what his take is on the tension between the United States and China around the Wuhan laboratory and COVID-19. I believe that he got everything about right in that it is extremely unlikely at the Chinese are truly hiding anything substantive. Because of their suspicious and somewhat paranoid nature it is likely that they were in denial about the outbreak in the early months and we're not really trying to hide anything but we're trying with almost wishful thinking that it would go away without anybody knowing about it. However, they did quickly come around identify the virus and make the sequence publicly known. This argues against any attempt to truly hide anything. All of the other stuff is a reflection of their suspicious nature. He also feels that there was no way that they would allow an outside investigative group into their labs anymore then we would allow a Chinese-led international group to come to the Fredrick lab. Jeff believes as I do that the only way to make any headway in all of this is to have a good faith collaboration between Chinese and other international scientists including United States scientists in order to cooperatively try to find the source of the origin of SARS Cov-2. Also, as a result of his in depth understanding of Chinese culture , he feels strongly that the Wuhan lab would not have been used for any deleterious research such as bio warfare. He confirmed the doctor Shi is a highly respected scientist and her reputation would argue against her being involved in anything outside of the realm of science. I expressed to Jeff that I agree with much of what he says , but the environment in the United states is so toxic with regard to China and the delusions of the far right radicals, that it is unlikely that we could come to a collaborative approach with the Chinese to come to a better understanding of the origin of COVID-19. Just got an email now from Ian Lipkin asking if he could arrange a phone call between him, me ,and Nancy Messonnier. I wonder what this is going to be all about ? PRESS: WINS Radio NYC 1010; Podcast on Progressive Voices Network – “Before you know it….” with David Bender; important defense of me by “The Times Leader” - https://www.timesleaderonline.com/uncategorized/2021/06/envy-is-the-rights-real-problemwith-dr-fauci/ June 26, 2021 – Global - USA – 33,400,000/601,000 I had a very interesting evening last night. Christine and I had dinner over the home of Sally Quinn. Other guests were Bob Woodward and Elsa Walsh as well as Rick and Jane Atkinson. We had a lot of inside the Beltway discussions about Bob's books and Rick’s books and the experience that I had with Trump during the last year of his presidency. In addition, I had the opportunity to see Quinn Bradlee and who I believe is his wife or girlfriend. Sally was very pleased that I had done a podcast with her son Quinn. Fox News continues to come after me by making false accusations that I have misled congressional committees during questioning under oath. they just do not want to stop harassing me, but that is going to go nowhere. June 27, 2021 - Cases continue to slowly come down: PRESS: Latest thing on Fox News over the last couple of days is that they are accusing me a lying under oath at a house and energy subcommittee hearing when I said That I did not know the precise reason why the president told us to cancel the WuHan grant. The fact is that we were told via mark meadows that we need to cancel the grant and when we told them that there has to be a specific reason the White House said we don't need a reason , just cancel the grant. When doctor Collins and doctor Tabak and indirectly when I said that it was illegal if we didn't have a specific reason , the White House came back and said make up a reason. Therefore, what I said under oath at the hearing is absolutely true. From a review of Jasmeen Abutaleb’s and Damian Paletta’s book by William Hanage of the Washington Post: Over and over again, whenever public health and public relations came into conflict, public health lost out. Trump’s complaints directed at “the Doctors” kept coming back to the same charge — negativity — including a remarkable, petulant presidential Oval Office outburst roughly halfway through the book. “I am sick and tired of how negative you all are. . . . I spend half of my day responding to what Tony Fauci has to say, and I’m the president of the United States!” Later in the same exchange, Trump told coronavirus response coordinator Deborah Birx: “Every time you talk, I get depressed. You have to stop that.” As if the pandemic could be defeated by the power of positive thinking, and Birx should just cheer up and promote policies that she knew would lead to more illness and death than the alternatives. I received a call today from David Wilman, who I thought was a friend and who has been having a conversation with me regularly every Sunday for the last several months in order for me to keep him up to date on what is going on with COVID. He was hinting early on that he was working on a story on gain of function research. He never interviewed me at all on the details of this but today he calls me up telling me how much he respects me, but he has a heads up for me that he is doing a story on gain of function and that I am in the story. He then went on to describe how much he respects me and that my favorite saying “precision of thought, economy of expression “ is one that he lives by and has it pasted on his computer. This looks to me like a hatchet job on me is coming and he is telling me what a great person I am before he drops the bomb. We shall see. June 28, 2021 – Global – 181, 000,000/3,900,000; USA – 33,500,000/602,000 PRESS: BET Instagram with Mark Tallman and Ronreaco Lee; Month of Action Zoom with Partner organizations; June 29, 2021 Delta variant swarming globally. It definitely is a more efficient transmitter. WHO is now recommending that even vaccinated people wear masks. Vaccinated people are getting infected, but without serious disease. FLOTUS sent Chris and me and the family a beautiful basket of vegetables grown in the White House Garden: Scanned from a Xerox Multifunction Dear Sir, Many in Australia, self included, have admired your steady hand in heavy and often dangerous seas. I saw this cartoon recently ... and I hope you like it … in the nicest possible way! Regards, Brian Dawes, Perth, Western Australia. PRESS: Constituency Hispanic TV (x3); NBC Nightly News with Lester Holt; ABC World News Tonight; PBS NewsHour with Judy Woodruff; PSAs; CNN with Don Lemon; See below: This is the Hearing that the GOP called with crazy witnesses and they wanted Francis Collins and I to testify. Pelosi and WH said no way House Republicans hold own hearing on FOX: COVID-19 origins GOP lawmakers claim Pelosi is holding up full committee hearings: Rep. Jim Jordan, R-Ohio, said that Fauci "didn’t have the courage" to "come defend himself" at the hearing. "I’m convinced these guys knew right from the get-go what the truth was and they misled the American people," Jordan claimed, citing a slew of Fauci emails made public in early June. "He showed up everywhere for a year and a half. You couldn't go a day and not see Dr. Fauci somewhere, he was everywhere and now when we have emails… all this evidence suddenly you can't find him." Kate Messner’s Children’s Book – “Dr. Fauci” has come out. It is beautifully done and obviously well-researched. June 30, 2021 – Global 182,000,000/3,900,000; USA – 33,500,000;602,000 I just received an assembly concurrent resolution number 195 of the 219th legislature of the State of New Jersey it is a concurrent resolution honoring the life and the work of Dr. Anthony Fauci. (see below) Scanned from a Xerox Multifunction Parting note to me from General Gus Perna upon his retirement: Tony, thank you for your note and very kind words! It truly been my honor and pleasure to work with you! I brag to my circle of friends about you - ‘always had time to say hello or explain anything to me, as well as, impeccable moral courage to do the right thing’. Thank you for all that you have done for our Nation - you are one of my personal heros!!! Best of luck with all your future endeavors!!! Vr Gus PRESS: MSNBC “Morning Joe” with Joe Scarborough; WTOP Radio; July 1, 2021 It is becoming very clear that the extreme far right in the press with Fox News, in social media but the far right crazies, and especially in the Congress with the senators and congressmen who are frightened of former president Trump and who are using attacks on me to show their loyalty to Trump. The issue that they are focusing on mostly in recent days is saying that I perjured myself in front of the House and Energy Subcommittee Hearing by saying I did not know why we were asked to cancel the Wuhan subgrant. In fact, I had checked with Francis Collins and Larry Tabak just to be sure , and there is no doubt that we were told by the White House to cancel the grant and not ask any questions about it. When we said that we had to have a specific reason for canceling the grant since it would be illegal for us to cancel it without a specific reason , the word came down from the White House predominantly via Mark Meadows that we should just go ahead and make up a reason but we definitely had to cancel the grant or else. The general counsel of HHS under Bob Charrow agreed that we had no specific reason to cancel the grant and so we had to reinstitute the grant but withhold funding until they met certain conditions which would be very difficult for them to meet anyway. It really was a work around to prevent us from funding the grant. Therefore, I was completely honest in saying that I did not know why the grant was asked to be cancelled since they never gave us a specific reason to do so. The pressure on me is extreme!!! They “bad guys” are taking everything I say and quoting it out of context. Really trying to destroy my credibility. Cases starting to go up a bit in the unvaccinated areas. Must watch closely Fauci: Divergent vaccination rates PRESS: Axios - could create "two Americas" I taped the Sunday “Meet the Press”. It will be a 4th of July Special. July 2, 2021 – Global USA COVID-19 cases in UK increase 67%, but hospitalizations are not going up indicating that vaccines are preventing severe disease. PRESS: Regional media TV with: WRAL NBC Raleigh-Durham; WSB-TV – ABC Atlanta; WREG-TV – CBS Memphis; July 4, 2021 Today is the celebration of the independence from the virus. There was the most beautiful display of fireworks on the mall that I have ever seen. Let us hope that the congregation of people at the celebration does not lead to a discernible surge in cases . As I have said on various TV shows including on Meet the Press this morning, there is a possibility of being two Americas, one that is vaccinated without any surge of infections and one that is unvaccinated leading to regional surges such as in those southern states with 35% or less of their population vaccinated. This includes places like Missouri , Alabama , Mississippi , Louisiana, Wyoming , among others. PRESS: appeared on NBC “Meet the Press” 4th of July Special with Chuck Todd July 5, 2021 - Global USA Cases increasing in certain regions. Will watch carefully to determine whether this has impact on hospitalizations. We will brief the president tomorrow about the role of Delta variants with regard to vaccine protection. Virus lab leak theory dogs Democrats eager to keep focus on Trump's Covid failings Democrats worry that murky conclusions that don’t identify the origin of the virus could play into the Republicans’ hands. July 6, 2021 - Global USA A considerable amount of concern about the fact that reports from Israel indicate that the Pfizer vaccine is less protective against infection since the protection a few weeks ago prior to the emergence of the Delta variant was about 94%, whereas now that the Delta variant has emerged, protection against any infection is down to 64%. However, the good news is that the Pfizer vaccine is still more than 90% effective against serious diseases including hospitalization. It is conceivable that this discrepancy about the efficacy against the initial infection is due to the fact that the Israelis are doing a lot more testing of asymptomatic people than other countries including the United States. This needs to be followed closely. • I participated as I do most of the time in the weekly Governors’ briefing. I explained to them the situation of the threat of the Delta variant. I had my weekly briefing of the President today. This time I did it in person in the Roosevelt Room of the White House. We discussed the situation of the degree of protection afforded by our vaccines against the Delta variant. I also explained to him the situation regarding the Israeli data ( see above). The president remarked how much Jill enjoyed traveling with me and he thanked me for that saying that it means a lot to them. PRESS: I did YouTube interview with two African American physicians from California: Doctor Jamie Rutland and doctor Italo brown. We discussed how we handle vaccine hesitancy among African Americans and how we can use the barbershop environment to convince them to get vaccinated. July 7, 2021 – Global – 184,000,000/4,000,000; USA – 33,600,000/604,000 We are stuck at ~12,000 to 14,000 cases per day: See below. It is very clear that the Israelis are increasing greatly their testing that could explain their results on asymptomatic infections in vaccinated people (see above and figure below): I had a very important meeting today with the NSC led by Beth Cameron and Maher Bitar who is the senior director for intelligence programs at NSC. We met in the EEOB SCIF and discussed the briefing document that the NSC had presented to the President a week or so ago. Beth wanted me to have an official briefing because of the catastrophic briefing that the amateurs from the CIA gave me several weeks ago. There were no new surprises for me in the briefing except that it became clear that the FBI has no idea what they're talking about since they are convinced that the origin of COVID-19 is from a laboratory leak. The reasons that they give do not make any sense. In contrast the NSA gave some reasonable hypotheses leaning heavily towards a natural jump of species in the environment. I spent some time explaining to Maher and Beth my own theories that the Chinese act like they're covering up something even when they have nothing to cover up. They manifested this in their response to the original SARS-CoV-1 when they insisted this was just an atypical influenza when in fact it was the beginning of a coronavirus pandemic. In addition, they likely shot themselves in the foot when they denied the presence of wild animals in the market when we know they were present and the Chinese cleaned out the market before adequate testing of animals could occur. In essence, they clouded the possibility of proving a natural emergence. I urged the NSC folks to work closely with qualified card-carrying evolutionary virologists such as Kristian Andersen, Eddie Holmes, Bob Garry, Andy Rambaut, among others. I also explained to them the multiple reasons epidemiologically and molecularly why it is almost certain that the virus evolved naturally from a species jump, even though I emphasized that I keep an open mind about the possibility of a lab leak . However, in this regard , I emphasized that just because two alternatives are possible that does not mean that they are equally probable. I believe that they understood where I was coming from and that it turned out to be a very good meeting. PRESS: Interview with Frank Bruni for his book on aging; interview with Betsy McKay of WSJ on GoF; Sirius XM Radio with Marc Siegel; MSNBC with Chris Hayes; July 8, 2021 - Kristian Andersen, Bob Garry and many others came out yesterday with on a preprint server a paper strongly arguing with good evidence for a natural emergence of SARS-CoV-2 rather thsan a lab leak: The Origins of SARS-CoV-2: A Critical Review https://bit.ly/3jSK1Ep CNN: “Coronavirus almost certainly came from an animal, not a lab leak, top scientists argue” I had a very useful and enjoyable conversation with the President of Chile – President Sebastian Pinera. He was very gracious and wanted advice from me about how to handle the outbreak in Chile looking forward. He was very complimentary to me in many waves and asked a number of very intelligent and important questions relevant to his country. He seems like an extremely engaging person and it was an enjoyable half an hour that I spent speaking with him via zoom. PRESS: NPR – “All Things Considered” with May Louise Kelly; July 9, 2021 – Global – 185,000,000/4,000,000; USA – 33,600,000/604,000 is waning after a period of several months. This created a lot of confusion and we all gathered on multiple phone calls yesterday evening in order to come out with a statement jointly from the CDC and FDA indicating that at this time if you are fully vaccinated you do not need a booster shot. In the middle of all of this I called up Mikael Dolstein and try to find out what was going on. He said that their statement was based on the Israeli data as well as data from their original phase three study which showed a modest degree of waning immunity after several months. Later in the evening I received a phone call from Pfizer CEO Albert Bourla who was very sorry and apologetic that he did not Alert me about the Pfizer announcement ahead of time. We will be arranging a meeting next week likely on Monday July 12 to discuss all of this with the visor people. PRESS: Instagram with Ana Navarro; NBC Evening News; CNN “Situation Room” with Wolf Blitzer July 10, 2021 Wasting a lot of time responding to letters from Congress and Senate about Wuhan. Egregious waste of time!! Much concern about the Delta variant. Cases coming up in USA: July 11, 2021 – 33,000 cases yesterday. Clearly the unvaccinated are getting infected PRESS: ABC “This Week with George Stephanopoulos”; CBS “Face the Nation” with John Dickerson; CNN State of the Union” with Jake Tapper; July 12, 2021 - Global USA It is important to point out how many hours we are all wasting in responding to the multiple letters from senators and congressmen fundamentally driven by conspiracy theories that the NIH has funded work at Wuhan institute of virology that lead to SARS-CoV-2. For example, over the weekend I was on multiple zoom calls with my staff fine tuning the letters in response to the multiple questions from people like senators Rand Paul, Marshall, Burr. I am somewhat surprised that's senator Burr was part of this since he generally is a friendly person to me. We had a very important meeting today by zoom with Mikael Dolsten and others from Pfizer with members of HHS including myself, Rochelle Walensky, David Kessler, Francis Collins, Janet Woodcock, all of the people from ASPR such as Dawn O'Connor. The Pfizer people present the data from the Israeli study which we already knew showed a decrease of efficacy against all infection down to 64%. In addition they showed some of the follow-up data from their phase 3 trial which showed a decrease in efficacy down to 83%. Clearly, Pfizer is intending to suggest boosts particularly for those who are elderly and with underlying conditions . In Israel they are already boosting some of the elderly and those with underlying conditions. There was a big debate in our own country and worldwide about giving a third shot to fully vaccinated people when most of the world is completely unvaccinated. This is a debate that will intensify. I believe we need to go ahead and explore the possibility of needing a boost at the same time as we provide vaccines for people in low and middle income countries. I have been emphasizing in my public appearances that the requirement for a boost does not mean that the vaccines are not highly effective. A boost relates to the durability of the protection not to the effectiveness of the protection. This is a concept that is often missed by the public. PRESS: CBS “This Morning” with Gayle King; NPR Baltimore – WYPR with Tom Hall; CNN with Chris Cuomo July 13, 2021 - Global – 187,000,000/4,000,000; USA – 33,700,000/605,000 New cases are increasing in at least 41 states. This is particularly true among seven states in the South where the percentage of people who are vaccinated is very low. It is clear that we are entering into a period where the steady decline in cases has now stopped and we are seeing an increase in cases with daily cases hovering around 33,000. There is a war of words going on between the Fox News TV hosts and democratic senators such as Richard Durbin. The attacks on me by the far right and Fox News (Tucker Calrson and Laura Ingraham) are relentless and occur on a daily basis. Marsha Blackburn, Marjorie Taylor Green, and all of the other nut cakes attack me on a daily basis . PRESS: CNBC “Squawk Box”; NPR “Here and Now”; MSNBC “Andrea Mitchell Report” July 14, 2021 I had a very pleasant experience today down at the White House where I engaged in a number of Instagrams, PSAs, and YouTube videos with the new sensational young entertainer Olivia Rodrigo. The purpose of the interaction was to encourage young people who are followers of Olivia to go out and get vaccinated. I was amazed to learn that with all her social media Olivia has 25 million followers. She is a very down to earth sweet 18 year old woman. The White House comms team for digital we're delighted with the interaction. • I'm spending a lot of time with the team in preparing for the July 20 HELP Senate hearing. This is all a colossal waste of time in which the far right is trying to link the COVID pandemic with work supported by NIAID In a sub award to the Wuhan institute of virology. I would likely get attacked by Senators Rand Paul , Marshall, Kennedy come on and Rubio among others. We shall see. July 15, 2021 – Global USA The republican Party has gone completely crazy. See letter below where Congressmen are accusing me of collaborating with the Chinese Communist Party: Follow Up NIH Re. Emails 71521 (2).pdf There are a few things to point out. For example, tonight we had a meeting that we generally have prior to briefing the president . Tomorrow we will be briefing the president and tonight at 9:00 PM we had a zoom meeting with me, Rochelle, Jeff , and Natalie to go over the plans for how we were going to breathe the president tomorrow (Friday). We divided the responsibility between Rochelle and me. Also, we had another one of the unusual experiences with the United states Congress. A group of 20 Right Wing Republican Congressman wrote a letter to Francis Collins and me asking a number of ridiculous questions in an accusatory manner as they have been for the last several weeks. In fact, the letter was first sent to the right wing publication the Daily Caller who then called us up and asked us what our response to the letter was when we had not yet even received the letter. And so, it was quite obvious that they were doing it mostly as a publicity stunt. In any event, one of the most amazing parts of the letter was the part where they made the statement: “Doctor Fauci was working closely with the CCP (Chinese Communist Party)”. They gave a reference for that statement that was an email sent to me from George Gao on March 28th 2020. In fact, that email was George apologizing to me for seemingly contradicting me in an article in Science in which he said that the United States was making a mistake by not recommending that people universally wear a mask. He did not want that to be interpreted that he was criticizing me and he apologized. In addition, George was saying how concerned he was about the outbreak and that he was worried about me and hoped that I was doing well. I wrote back to him and said “Thank you for your kind note I hope that all is well with you.” If anyone can construe that exchange as my working closely with the Chinese Communist Party, they have to be out of their mind. For that reason, it is clear that these types of letters are nothing but a bunch of unmitigated bullshit. PRESS: Local print media – Las Vegas Review Journal, Arkansas Democrat-Gazette, Gannett Missouri; July 16, 2021 I briefed the President in the Oval Office today about the Delta variant and its impact on our country. Present at the briefing were: Ron Klain, Susan Rice, Natalie Quillian, Jeff Zients, Anita Dunn, Brian Reese, Mike Donilon and Rochelle Walensky virtually. Given the increasing number of cases in the United States, even though the hospitalizations have not increased, the President was concerned that his message that by July 4th we would be seeing an independence from the virus here in the United states might actually be now subject to question. We spoke to him about the importance of emphasizing that vaccinated people do not get severe disease even from the Delta variant . In addition, we pointed out the possibility that we may need to give booster shots , namely a third dose following the two doses of the mRNA vaccine. The President was concerned that people would say that he was giving a mixed message when he asked everyone to get the standard regimen of vaccination and now we are telling them that they may need to get an additional dose. I pointed out to him that most people who are vaccinated would be quite amenable to getting a third dose so long as they thought it would increase the duration of their protection and or make them more highly protected. It is the people who do not want to get vaccinated to begin with who are going to be in trouble because they will get infected and they will need hospitalization. The POTUS and Jeff kept asking whether I thought that it would get as bad as the winter of 2020/2021. I said no since we did not have vaccinated people back then. Fox News hosts Tucker Carlson and Laura Ingraham and mocking our attempts to get people vaccinated likely leading to loss of lives. Rand Paul and Jim Jordan tweeting about me all the time and actually raising money by trying to discredit me Cases continue to climb: PRESS: MSNBC – “The Reid Out”; Peacock MSNBC – Joshua Johnson; CBS Evening news; NBC Nightly News with Lester Holt; July 17, 2021 No change. Cases continue to rise. Gov. DeSantis has made anti-Fauci T-shirts. Amazing!! PRESS: CNN with Jim Acosta; July 18, 2021 Cases continue to increase. The question that is being asked is whether fully vaccinated people who have breakthrough infections can transmit the infection to others. Still no direct data either way: July 19, 2021 Jeff Z. called me early this AM (6:45 AM) concerned about the breakthrough infections of vaccinated people and waned my opinion about moving towards masking of vaccinated people who are in hot zones. I think that we should. Jeff called again at 10:00 AM concerned about the time FDA is taking to grant a full BLA for the vaccines. He is acutely aware of the sensitivity of not interfering with or pressuring the FDA, but we need the BLA since many people are not getting vaccinated until the vaccines are “fully approved”. Also, Jeff want me to get firm information on how long it will take for the peds (11 years old and younger) approval to come. Stock Market plunging >700 down due to concerns about the spread of the Delta variant. Mayor Bill Di Blasio called and ask my opinion about a strategy that he would like to do to try and get more people vaccinated and safe from the delta variant. He is proposing to give the people of New York City two alternatives if they are not vaccinated: 1) get vaccinated or 2) be required to get tested with a nasal swab at least once a week. The mayor feels that people will likely get tired of getting tested every week and my opt to get vaccinated purely for the convenience of it. Even though the requirement for a nasal swab is indeed a mandate, the mayor feels that this is much less intrusive they mandate for a vaccine. PRESS: CNN with Kate Boldun; Bloomberg TV “Balance of Power” with David Westin; PBS NewsHour with Judy Woodruff July 20, 2021 – Global – 191,000,000/4,100,000; USA – 34,000,000/607,000 Testified today before the Senate HELP Subcommittee - There was the expected big splash at the hearing today As Senator Rand Paul accused me of lying under oath at a prior hearing and asked me if I wanted to retract my statement when I said that the NIAID has never funded nor does it funds now gain of function research at the Wuhan Institute of Virology. He referred to the Plos Pathogens paper of 2017 and insisted that there was gain of function in those experiments and said I therefore lied. He quoted Dr. Richard Ebright as saying that those experiments were definitely gain a function. I exploded right back at Senator Paul and told him that he had no idea what he was talking about. I told him that I did not lie and have never lied certainly not before the Congress and then I would not at all retract anything I previously said before a congressional committee. He then implied that the work that we were doing may have been the cause of thousands of deaths. At this point I blasted back at him that if that is what he is implying he has no idea what he is talking about because the viruses that we were dealing with and that were in the progress reports and that are in the literature in no way could become SARS-CoV-2. I went on to say that it was molecularly impossible for the viruses that we were dealing with to become SARS-CoV-2. I finished by looking him in the eye and telling him that if anybody is lying here it is he. Several of the other senators on the democratic side after the discussion between Paul and me was finished made statements saying how confident they are in my integrity and in my service. Senator Marshall later asked questions about the furin cleavage site and the CGG codon. Then he started talking about the S1 segment of the spike protein and had absolutely no idea what he was talking about. He rambled on until I told him that I had no idea what he was saying; it make no sense. He made a fool of himself. Cases continue to climb: PRESS: CBS “This Morning”; Multiple stories on TV about my encounter with Senator Paul July 21, 2021 – Global – 191,000,000/4,100,000; USA – 34,000,000/607,000 Cases continue to climb: Typical e-mail from a supporter of me after the Rand Paul clash. One of dozens and dozens: Dear Dr. Fauci, I've wanted to write you at various points over the last year, but seeing the hideous treatment you received from Rand Paul played on the PBS "Newshour" last night has prompted me to wait no longer. My husband, Breck Montague, and I want to thank you from the bottoms of our hearts for the inimitable leadership, courage and wisdom you have shown since you've had to become a frequently called-upon national spokesperson for good health sense and public health during this pandemic. I am certain you remember my father, Frank Williams, during his time as director of NIA. I actually recall when you came on board at NIAID -- I believe my father marvelled about how you were perhaps the "youngest person ever" to assume an NIH directorship. If so, thank goodness you were, because here you still are, with the benefit of decades under your belt, at such a critical time. Thank you for telling Sen. Paul it was he who was lying -- and for not accepting his dangerous rhetoric. We were so proud of you! In our rural community, we do everything we can to support fact-based conversation and exchange of information. In such a disheartening period in this country's history, we're immensely grateful to have leaders such as you who speak out and act according to your beliefs. Keep it up, and please accept our support and thanks. Mary Williams Montague Gloucester, Virginia (8576 Toddsbury Lane Gloucester, VA 23061) Francis Collins defends me against Rand Paul nonsense on CNN and MSNBC tonight I visited Eric Lander (Director of OSTP) at the White House today. He asked for the meeting and wanted to do two things. First, he wanted to express his strong support for me in light of what just went down with senator Paul. Second, he wanted my help in trying to nail down the possibility of our getting much of the $30 billion that are still available from the JOBS Act to put together a major program for pandemic preparedness for the future. He wanted to work with Francis Collins and I to make this happen and suggested that we might write an op Ed together. This evening I got a text from Beth Cameron of NSC. Beth indicated that I was her hero for what I did with Rand Paul and that she had heard from Eric Lander that I was discussing with him the issue of the $30 billion. I texted her back saying that I would push hard for this with Ron Klain and Jeff Zients. I will be seeing the President in the Oval Office today and hopefully Ron will be there so that I can discuss this with him. It should be pointed out that I have been meeting with the president personally in the Oval Office once a week for the past several weeks. It seems that Jeff prefers that I am there personally during the Presidential briefings. Also, it is rather strange that it seems that Jeff does not trust the CDC or even Rochelle and always wants me involved when it comes to the President. This may be a bit unfair to Rochelle, but his skepticism about the CDC historically is justified. In the meantime, the GOP led by despicable Kevin McCarthy continue to push back on doing an adequate investigation on what led up to the January 6 insurrection against democracy. Thank goodness that Nancy Pelosi has rejected the GOP suggestion of putting Jim Jordan on the panel that would be investigating the January 6 insurrection. Also, the GOP continues to blast me in their social media. It seems like it is an all out war between me and the radical right wing of the GOP PRESS: Interview with Sentinel Record (Zoom) – Arkansas newspaper with Tyler Wann; NPR “All Things Considered” with Mary Louise Kelly; CNBC “Closing Bell”; MSNBC with Ari Melber July 22, 2021 – Global – 192,000,000/4,100,000; USA – 34,000,000/608,000 Daily cases continue to climb: Had my usual weekly meeting with the POTUS today at 1:00 PM in the Oval Office. Also present: Jeff Z., Natalie Quillian, Mike Donilon, Jake Sullivan (NSC). When I walked into the Oval the POTUS put his hands on my shoulder, brought me close and said: “You did a great job in stuffing that horse’s ass” referring to Rand Paul. He also said that 1st Lady Jill was “cheering for me” as she watched it on TV. As I walked through the White House, several people thanked me for “my service and for what I do” and a few remarked about Paul and said how proud they were of me. Briefed the Senate and House by Zoom together with Jeff, Natalie, and Marcella Ninez-Smith England surging with USA following: Steve Scalese is now promoting vaccines. It seems that several of the GOP who were originally against vaccines are now realizing that they are on the wrong side of history. PRESS: CBS Evening News with Norah O’Donnell; Twitch Livestream; July 23, 2021 I had a very productive conversation in my regular every two week call with our UK colleagues – Chris Whitty and Patrick Vallance, this time accompanied by Thomas Waite. I explained to them the situation that we have here in the United states with the delta variant. The UK seems to be a couple of weeks ahead of us in every way. They have vaccinated a slightly larger proportion of their population than we have and the surge in delta that they are experiencing is much steeper then what we have at this time. The efficacy of the vaccine against hospitalization and death continues to hold. They are a skeptical about the Israeli vaccine efficacy data for asymptomatic and mildly symptomatic disease as we are here in the United States. The UK has made the decision similar to us that they will try to get all the children back to school in person by the fall. However unlike us, the unvaccinated children will not be required to wear masks when they go back to school. They have essentially decided that since you cannot vaccinate the younger children yet and since they generally have very mild disease, that you should accept the fact that sooner or later these young children are going to get infected and so be it. They do not want to close the schools or go to virtual learning. I will continue to follow the situation with them since it is very helpful to us here to learn what the UK is doing. Of note, both Chris and Patrick wanted me to know that I am held in extremely high regard in the UK by virtually everyone on the basis of my standing up to Rand Paul and his nonsense in the Senate Right-wing attacks on me intensify – North Carolina GOP Congressman Madison Cawthorn - "I thank Rand Paul for bringing it up and I will tell you right now Anthony Fauci does not have the best interests of the American people at his heart," he said. "I believe he is a pawn for the Chinese government by giving them funding to do militaristic funding to try and figure out how they can make an animal virus more transmissible to humans. It's disgusting, it's wrong, and 4 million people are dead all around the world because of it." Did my usual weekly briefing of the Cabinet (“Principals”) together with Rochelle, Natalie, Jeff, and Vivek. Brought them up to date on Delta variant becoming dominant. PRESS: CBC (Canadian) “Power and Politics; FOX with Neil Caputo; PRESS: Very good article in the LA Times by Melissa Healy: LA Times: Fauci: ‘There’s no way’ the coronavirus was made with U.S. research funds. Here’s why https://lat.ms/3ruPOC6 July 25, 2021 – Global USA The USA is not doing so great in vaccinations compared to other developed countries: Fully vaccinated people: PRESS: CNN “State of the Union” with Jake Tapper; MSNBC “Sunday Show” with Jonathan Capehart; July 26, 2021 Humor: Important stuff going on!!We had at least two zoom meetings today with Jeff, Rochelle, Vivek, and Bechara to discuss the upcoming change in masking guidelines that the CDC will be proposing. It relates to the fact that data or showing that the level of virus in the nasopharynx of vaccinated people with asymptomatic breakthrough infections is similar according to CT values to that in individuals who are infected asymptomatically and who have not been vaccinated. These data are strongly suggestive that individuals who are vaccinated and who get infected can't transmit the virus two others as easily ask an unvaccinated people. This is triggering the need to tell vaccinated people that when they go to situations that are indoors that now they have to wear a mask or should at least seriously consider wearing a mask depending on the level of infection in the community where they are living. Rochelle is really having a very tough time in negotiating this with Jeff in the context of “her team” at CDC that seems to be operating in their usual manner independently of running things by the White House. For example at the end of a long and tortuous discussion about getting the wording correct in the new guideline, Rochelle let us know that two days from now (Wednesday) the CDC will be coming out with an MMWR that will overlap with what we have been wordsmithing for the guideline. Jeff and everyone else was blown away that these two parallel things were going on and we did not even know about it. I feel badly for Rochelle since she is dealing with an ingrained CDC system that has been that way for the decades that I have been dealing with them. Jeff and the White House Comms people (Courtney Rowe) are very concerned about mixed messaging. We decided that we would sleep on this and address it again in the morning. July 27, 2021 – Global – 194,600,000/4,200,000; USA – 34,500,000/609,000 Just got a call from Jeff that he wants me to brief the President today about the issues discussed above. It is very clear and unfortunate that confidence in Rochelle is very low within the White House team of Jeff, Courtney Rowe, and others. STAY TUNED Had a good conversation with the President in the Oval Office this afternoon at 12:30. I explained to him the new CDC guidelines for wearing masks indoors even if you are vaccinated given the fact that the delta variant is causing breakthrough infections in vaccinated individuals and vaccinated individuals with breakthrough infections can transmit the virus two uninfected individuals. In addition, I explained to him the data that the level of virus in the nasopharynx of vaccinated people with breakthrough infections is similar to the level of virus in the nasopharynx of unvaccinated infected people. We had a good conversation; he asked a lot of good questions. Right before the discussion he was on the phone with former senator Barbara Boxer who had just been mugged outside of her house. She asked to talk to me when she heard that the president would be meeting with me and we had a good conversation. She relayed that she felt very badly that idiots are attacking me and that she always has had the highest degree of regard for me. She recalled back in the days when we were fighting HIV together. I asked the president if Jill had come back from the Olympics in Tokyo. The President informed me that she had and so I sent her my regards through him. As Jeff , Natalie Quillian, and I were sitting in front of the Resolute Desk, I had a very strange, almost out of body experience. I just recalled at that time so clearly the bizarre situations that I had been through in the past when I sat in front of the desk trying to brief President trump. I recalled his incredible lack of concentration ability where his attention span was measured in seconds rather than minutes. This is in stark contrast to the seriousness, dignity, and integrity that now permeates the entire White House, particularly the Oval Office. Only now in retrospect do I fully appreciate what a disaster Trump was as President. This applies not only to his policies, but to the fact that he diminished the dignity of the presidency enormously. The feeling in the Oval Office now is very similar to what I experienced when I was in the Oval Office with presidents George HW Bush, George W Bush, Bill Clinton, and Barack Obama. This is such an entirely different feeling and vibration that I have when I enter the room and sit down either on the couch or in front of the desk. There was always that feeling of anxiety with Trump where I was anticipating that he would say or do something outlandish. PRESS: Big announcement from CDC about masking for vaccinated people indoors attracting much media – Print interviews with NY Times and Washington Post. The Intercept: Rand Paul’s Attack on Anthony Fauci Chills Scientific Debate Over Gainof-Function Research https://bit.ly/3iR7zHP NEWS CLIPPING — BUZZFEED — CONDENSED (3 SOURCE PAGES) “The Black News Channel “The World Tonight”; NBC “Nightly News” with Lester Holt; NPR “All Things Considered” with Ari Shapiro; PBS “NewsHour” with Judy Woodruff; Univision National TV; Telemundo TV; CNN with Chris Cuomo; MSNBC…” "Getting death threats for me and my family and harassing my daughters to the point where I have to get security is just, I mean, it's amazing," Fauci said during an online forum last year. At that time, he called the threats "unseemly things that crises bring out in people." Fauci told CNN this week that the US is "going in the wrong direction" in terms of COVID-19 cases. He blamed unvaccinated Americans for the surge in infections, particularly with the more contagious Delta variant. Connally is due to appear in a federal court on Wednesday. Story also covered in other media – New York Post, Axios, Forbes, Newsweek, CNN, The Hill July 28, 2021 – Global USA Cases continue to surge: PRESS: MSNBC – “Morning Joe” with Joe Scarborough; Joe Madison Radio Show; Morning Hustle Radio Show; July 29, 2021 There are a lot of important things going on that I do not have a chance to comment on in my daily diary. Some of these are the continual conversations that I have been having with Jeff about who should be the FDA Commissioner. Jeff and Ron Klain continue to run by me names of potential candidates. Today for example, David Kessler came to me with a surprising request that I float his name to Ron as a possible candidate. David is currently the head of the countermeasure acceleration group (CAG) of HHS. He is a former FDA commissioner and would likely do a very good job. I will float his name and see what happens. In another vein, I continue to get harassed by letters from far-right congressmen and senators who are cherry picking my FOIA’d emails and trying to establish that I have lied under oath when I said that the NIH has never done gain of function research at the Wuhan institute of virology. In addition, Tucker Carlson and others at Fox News continue to attack me virtually every night. Carlson saying multiple times that I created the virus. This is an extremely stressful situation but I will have to push on with the job that I have as director of NIAID and as chief medical advisor to President Biden. Another issue that is percolating it's a growing discontent with the CDC and with Rochelle’s difficulty in clearly articulating their somewhat shifting positions such as that of masking indoors. I do not believe that it is Rochelle’s fault but it is a fundamental lesion in the CDC. One of the problems is the typical CDC mentality that antedated Rochelle. Rochelle and the CDC are hesitant to show anyone data that backs up their policy because it is supposedly “embargoed. The problem is that the embargo relates to the MMWR, which is the CDC's own publication. Therefore it seems that if they wanted to break the embargo they could easily do it. Again, this is a recurrent problem with the CDC keeping data close to their vest and making policy without allowing outside experts to weigh in. It was an evolving situation here. Got a call from Jeff just now reading a sentence from the President's speech that he will give today in which he said that children do get infected, but a serious outcome is “extremely, extremely rare”. In my meeting with my office team this morning someone pointed out that in Arkansas on Wednesday there were 24 infections in children; seven of them wound up in the ICU and two of them are on respirators. I had originally told Jeff to get rid of one of the “extremelies” and just say “extremely rare”. After hearing about the infections in Arkansas I called back Jeff and told him to get rid of both “extremelies” and just say “rare “. We actually do not know the full impact of this virus on children at this point and so we really need to be careful about what we say and what we allow the POTUS to say. We are on a similar track as UK but a few weeks behind (as is usually the case): Very important essay by Peter Hotez: PLoS Biol/Hotez: Mounting antiscience aggression in the United States https://bit.ly/3lbsKXF We had a briefing today from the house Select Committee on COVID-19 chared by representative Clyburn. It was supposed to be limited to a discussion on the delta variant. However, it was clear that when the Republicans were allowed to ask questions they went off the subject and started to ask questions about infections coming over the border from Mexico. In typical fashion Jim Jordan asked me if I was a member of the P3CO oversight committee when in fact there is no such a thing as a P3 CO oversight committee. We have an executive committee of which I am not a member. Fortunately, even though I did not know what he was talking about, I said that I was not a member. He then asked for a list of the members. Since I really didn't know what he was talking about I said that I would get him that list. As it turns out, this is a list that HHS does not want to make public. HHS will get back to him and explain that to him. Obviously, he will make a big deal about this publicly. The Republicans in the Congress as well as Fox News continue to attack me viciously. I was particularly disappointed today to read Newt Gingrich whom I have always liked and respected came out and said that it was time for me to retire. He said that although I have had an illustrious career, I am trying to defend the indefensible. I am really not sure what he meant by that. Did he mean that I was defending gain of function research or did he mean that I was defending the CDC's masking guideline? As Peter Hotez said in the article above, no one is stepping up in the scientific community to defend me since they are afraid of being threatened by this extreme group that seems to be very well organized. Went to a book signing party add the home of Adrienne Arsh. The book is “I alone can fix it “ bye Phil Rucker and Carol Leonnig. The Super a list from Washington DC was there. It was a little bit uncomfortable since I was wearing a mask with the new guidance from the CDC and almost everyone else was without a mask. When they saw me with a mask , several of them put a mask on. One of the things for discussion in the book for this time frame is the extraordinary confidence that the president, Ron Klain, and especially Jeff is placing in me. When I briefed the president before his speech a couple of days ago , Jeff did not want Rochelle to brief the president even though the discussion was strictly about CDC guidelines. PRESS: South African TV – Bhekisisa Center for Health Journalism with Mia Malan; Ken Jeong Instagram; WTOP Radio; NBC LX TV; July 30, 2021 – Global USA There is growing frustration fall apart of Jeff with the CDC and particularly with Rochelle. I love her but she does not seem to have control over organization. We were being briefed the other night about what we were going to be saying about boosters and about the effect of the delta variant. In the middle of the conversation we found out that an MMWR was already written that could possibly be in conflict with what we were discussing. (see above). Now we have a situation where a slide set that was for internal discussion within the CDC was leaked by the CDC to the Washington Post including a discussion of things that we had not vetted out with the Medical Group. Jeff was extremely concerned that we are now on the defense trying to explain or defend things in an internal document that is now public. He called a special zoom meeting with himself , me , and Rochelle to try and sort this out. It became clear during the discussion that Rochelle herself was somewhat unaware of what her own CDC people were doing. I felt very bad for her because she is clearly very competent. we will have another zoom meeting later today since Jeff tasked me to review the papers upon which the CDC conclusion that the delta variant causes more severe disease was based. I will have myself, Andrea Lerner, Cliff lane, and Dean Follmann review the papers. After review by my “team” we found that the Singapore data was very weak but that the Scotland and Canada data suggest that there is an increase in severity with the delta variant. I communicated this both to Jeff and to Rochelle. I had a very interesting conversation with the Prime Minister of Israel, Naftali Bennett, who requested a zoom call with me. Based on the diminishing efficacy of the Pfizer vaccine in Israel, the Prime Minister together with his health ministers have decided that they will give a third booster shot to individuals older than 60 years old. They are already giving a booster to people who are immunosuppressed. the Prime Minister wanted to get my opinion and ultimate support of what he is doing. with my permission he taped our discussion so that he could put it on his Instagram to show to the people of Israel. I pointed out to him that there will be some concern that he is boosting people in his own population while much of the world has not yet received their first dose. He understands that but pointed out to me that is real is a country of almost 9 million people and they have just enough doses to take care of their own people , and unlike the United states, they do not have the resources to supply the rest of the world. He asked for my cell phone number so that he might intermittently call me for advice. With the approval of the State Department I gave it to him. It seems that we have developed a very good rapport on the basis of this first meeting. It turns out that the Prime Minister is an extremely interesting man who was a combat commander (Major) in the Israeli Defense Forces in a Special Forces unit. He led many Special Forces operations. In addition, he has spent many years in the United States and has made millions of dollars as a software entrepreneur. PRESS: Global National TV – Canada; Spectrum News TV – California; NPR – “All Things Considered” with Ailsa Chang July 31, 2021 – Global – 196,6000,000/4,200,000; USA – 34,800,000/610,000 Instagram from Israeli PM Bennett: August 1. 2021 – Global USA – 34,900,000/611,000 I got involved in an interesting situation regarding the expiration of the moratorium on evictions with the CDC in the middle of it. Apparently, the CDC has the authority to block evictions during a public health emergency. The moratorium expired and the Supreme Court ruled that they could not reinstitute it. Now Nancy Pelosi is furious because the public is blaming the Congress for not solving the problem. Pelosi is asking the White House to do it and the White House is turfing it to the CDC. The CDC does not have the authority to overrule the courts and so there's a lot of tension going on. Larry Horowitz who works with Pelosi called me to ask me to try and convince Rochelle to reinstitute the moratorium, get sued (which she will lose ), and thus give enough time to get money to the people who are being evicted to prevent their eviction. I got on the phone with Rochelle and offered to help her by giving her encouragement and support. It all worked out when Jeff Zientz worked with Ron Klain to have Rochelle write a letter to the president saying that she would love to keep the moratorium but it is legally out of her hands. In this way the good intention of the administration would be displayed , but they would not get into legal difficulty. PRESS: ABC “This Week” with Jonathan Karl; CBS “Face the Nation” with John Dickerson August 2, 2021 – Global USA I briefed the President today in the Oval Office. It was part of the weekly briefing that we do where Rochelle and Vivek and Marcella were on the zoom screen and I was in the office with the President and the Vice President. I briefed him on the efficacy of the vaccine against the delta variant as well as on the issue of breakthrough infections and the possibility of our need for boosters. The President was his usual pleasant and calm self; however, he seemed a bit troubled about two issues: first, he is aware that everyone is waiting for the FDA to give final approval to the vaccines and that this would go a long way to getting more people vaccinated. He clearly does not want to interfere with the FDA; however, he is growing impatient with the length of time that is taking for them to come across with a full approval. Second, he is concerned about the fact that the moratorium on evictions of people from their homes has expired and the Supreme Court has voted five to four that the moratorium cannot be extended. He has the power to call together constitutional scholars and claim that they have given him enough reason to overrule the opinion of the Supreme Court and order the CDC to continue with the moratorium on evictions. He is hesitant to do that since although he believes it is the right thing to do from a humanitarian standpoint, he does not want to set a precedent for a President to use his or her Presidential authority to overrule a Supreme Court ruling. He is afraid that if we get another President similar to Trump, that a lot of mischief and bad acting could occur if such a precedent were set. And so, he has to live with the uncomfortable situation of Nancy Pelosi essentially yelling at him on the phone to do something about the eviction situation when in some respects he is powerless to do so. I feel for him and I am more appreciative close and personal of the weight of the Presidency. As it turns out, the President did get an opinion from some constitutional scholars and made the decision to ask the CDC to extend the moratorium for 30 days. As Ron Klain said in the White House , it is likely that the courts will overturn this extended moratorium pretty quickly . We shall see. The general spin is that the president did this because of extensive pressure from Nancy Pelosi and the Democratic Congress. Governor Ned Lamont of Connecticut called me today in frustration that the FDA has not yet given full BLA approval to the COVID-19 vaccines. He asked if I could do anything about it . I explained to him that that would be difficult since it would suggest that we are putting pressure on the FDA which could backfire on us. I told him that I was very much in favor of accelerating the process and that I felt that the approval would likely come within the next couple of weeks . He also asked about booster shots and I explained to him that boosters for the immunocompromised would likely come very soon and that it would probably take a couple of months before there was enough data to recommend booster shots for the elderly. Got a call today from John Bel Edwards, Governor of Louisiana. He is having the biggest surge of cases of any state in the country right now and he is asking for my support in what he will soon do and that is to put in a mask mandate for all indoor public settings as well As for everyone in the school system which will start today. He asked if I had any further suggestions. I asked if he had ordered a restricted capacity or closing of bars and restaurants and he said that although he would like to do that, he feels that the legislature would rebel against him and take away his emergency powers for public health. And so he wants to get his mask mandate through as his first priority. I agree with him. In addition before we hung up he said that he really admired me and felt badly of what I was going through with the far right attacking me. He said a very nice thing when he said: “you have bigger clowns to deal with than I do; maybe not more clowns, but certainly bigger clowns, but at least you can sleep at night with a clear conscience “. The conspiracy of the far right and the trump loyalists continues. Recently representative Mike McCall the minority On the House Foreign Affairs Committee released a report by the panel's republican staff essentially saying that the lab leak was the cause of COVID-19 and hinting the NIH's role in creating the virus. This is based on no new information or no new data. It is very clear what is going on and it needs to be called out. It is all part of “The Big Lie”. First, trump actually won the election; next, January 6th was a friendly visit to the capital book shop; next trump was right and China caused the virus; next Fauci and the NIH helped the Chinese create the virus; next, discredit Fauci and it looks like trump is telling the truth. It is plain and simple a concerted effort aimed at getting trump re-elected and exonerating him from any blame in the complete mess up of his response to COVID-19. Lindsey Graham has contracted COVID-19 period since he is vaccinated he has a mild case. I asked his staff to have him give me a call , which he did and I expressed concern for him and offered to help if I could. He was very grateful for my concern instead we would keep in touch. PRESS: White House pressor; August 3, 2021 – Global – 198,000,000/4,200,000; USA – 35,200,000/612,000 We continue to average about 70,000 cases per day An ironic situation is going on in Florida where Governor DeSantis has a state that has the most infections per day in the country and is still insisting that mask mandates are not allowed at the local level by the schools or by anyone else. In addition, he continues to raise money by slamming me with T shirts as well as by his slogan “don't Fauci my Florida”. Besides being a total jerk, he is causing people to die in his home state. Did Governor’s call today – Chaired by Gov. Asa Hutchinson (R-AK) White House has asked me to interview candidates for the position of FDA commissioner. And so today I am interviewing Sudip Parikh whom I knew when he was the staff director for the Senate Appropriations Committee. I was impressed with his interview since he is a very smart and energetic person. I also interviewed James Hildreth who is currently president and CEO of Meharry medical school. I have known Jim for a long time and he is highly qualified. Gov. Cuomo is in serious trouble politically. A report came out today detailing 11 instances of sexual harassment. President Biden as well as Nancy Pelosi has called for his resignation . If he does not resign, he will likely be impeached. Richard Ebright (Rutgers) has proven again that he is truly an asshole. Francis Collins was on CNN this morning and misspoke saying that adults who have children at home should wear a mask at home , which is clearly not correct. However , Frances very quickly corrected his statement by putting out a tweet , apologizing , and saying that he was incorrect. Yet immediately after that doctor Richard Ebright followed this up with a very nasty tweet . See below: This evening I was asked by Erin Burnett on CNN to clarify the situation once and for all. I stated that Francis misspoke but to his great credit he immediately apologized and corrected the mistake. I e-mailed Susan Rice tonight asking her to call me, and she returned call at around 9:00 PM. I wanted to explain more fully to her the misperception about the “likelihood” that a vaccinated person would get infected. In a discussion we had yesterday where I briefed some of the economic leaders including Janet Yellin and Susan Rice, the question came up as to what it means when there is a 79% efficacy of a vaccine against the delta variant. Many people interpret this to mean that there is then a 21% chance that a vaccinated person will get infected . This is obviously incorrect since you must compare it to the unvaccinated people. Since not all the unvaccinated people get infected by any means, then the 79% protection compared to the unvaccinated people means that a very, very small proportion of vaccinated people will get infected. Susan was very grateful for the phone call and said as he has often dos when she sees me that she “loves” me. We have become good friends over the years dating back to the Obama administration, and I really like her. PRESS: Axios interview with Eileen O’Reilly; Podcast with Creative Artists Agency – agent for many entertainment and sports figures; Podcast with CSIS – Steve Morrison; CBS Evening News with Nikki Battiste; CNN with Erin Burnett; Did a Webinar with Virginia Governor Northam; August 4, 2021 – Global USA Had 100,000 cases yesterday!! 104,000 cases today I received the call today from former Vice President Dick Cheney - This is medically confidential and not for publication in my memoir. The VP was asked to give the eulogy for former Secretary of Defense and dear friend Donald Rumsfeld. Cheney had a heart transplant several years ago and is on immunosuppressive regimen. It is likely that his immune response two the vaccine is suboptimal. He called his cardiologist , Jonathan Reiner, at GW and asked his advice about coming to Washington to give a eulogy for Rumsfeld given the current situation with the delta variant. Reiner recommended that he called me. I made it very clear to Cheney that I strongly recommended he get the third boost of the mRNA since he is highly susceptible to getting infected if he comes into contact with an infected person. We spend some time discussing the courage of his daughter Liz Cheney and sticking up against the far right Republicans who want to whitewash the January 6th insurrection. I told him that she was a chip off the old block and I really appreciated the fact that she has been sticking up for me. Cheney said he admired very much my courage and fortitude and standing up for what was right and he is proud to tell friends that he knows me and used to work closely with me. I told him that the feeling was mutual when I talk about him to my friends. Call with Eric Goosby - Eric is concerned that we are not utilizing the infrastructure of PEPFAR to solve the distribution problem of vaccines in sub saharan Africa. Eric points out that the obstruction here interestingly is Gayle Smith who is now the special director in the Department of State for global affairs. Eric points out that it is the same competition intention between USAID and other global entities of the federal government. Gayle and USAID want to be the focal point of the failing distribution of vaccines in Africa, while PEPFAR already has an extraordinarily effective infrastructure that was built for HIV. Eric is frustrated that we are not using that infrastructure. Did Zoom with Senator Dick Durbin who wanted a briefing on breakthroughs and boosters PRESS: Katie Couric podcast; Wall Street Journal podcast with Ryan Knudson; Australian broadcasting TV “7/30” August 5, 2021 – Global USA I had a very busy day today. Jeff arranged for me to brief both the house and the Senate via zoom on the latest in the COVID situation. In addition , I joined the first gentleman Greg Emhoff in discussing with a bunch of young communicators the importance of their work in getting their young peers vaccinated. This is the second time that I have done an event with the first gentleman. In addition, I met by zoom with Kathy Russell the head uh White House personnel to debrief her on the interviews I did with FDA candidates James Hildreth and Sudip Parikh. During the debriefing when they asked me if there were any other candidates that I would recommend, I strongly recommended Zeke Emanuel. However, as usual there was a concern about the fact that he can be a bit of a loose cannon. This is unfortunate since he is a very talented guy , intellectually brilliant, and very visionary. He is also a good friend. The nonsense of the far right in trying to discredit me continues. A day does not go by without either the far right GOP congressman or senator criticizing me and even calling for my removal together with the far right media , particularly FOX, being sharply critical of me in every respect. PRESS: ABC “Good Morning America” with George Stephanopoulos; Rickey Smiley Radio Show; Taped CNN Fareed Zakaria for this Sunday; August 6, 2021 – Global – 200,800,000/4,300,000; USA - 35,500,000/614,000 67,000 7-day average Cases continue to climb. There has been a lot of discussion about whether or not we should move quickly in instituting a program. I have been a very strong and vocal advocate to give booster shots immediately to people who are immune compromised such as those who are transplant recipients, those war on cancer chemotherapy, and those who are immunosuppressed because the border immune diseases. I have been explicit about that and have also been pushing the CDC to give us at least some preliminary data on the cohort studies that they say will inform us about the durability of protection among various groups of people. Other countries including France, Israel, and Germany, have decided to give boosts to the elderly right now. The UK has decided that they will start doing this in September. In this context, Jeff is getting very disillusioned with Rochelle and the CDC in their traditional way of not giving anyone even a slight hint of what the data shows until they are ready to announce it officially. A typical example of this has occurred today. I will be on a lot of press calls today and over the weekend and the CDC just announced that they have an MMWR that will be coming out together with a couple of papers in JAMA. I have no idea what is in these publications. This is unacceptable . Similar to what Sylvia burwell discuss with me years ago about firing Tom Frieden, Jeff is seriously thinking about either bringing in someone else to assist Rochelle or outright getting rid of her. I have argued that we should absolutely not fire her, and I have offered to speak with her about this issue. I had a long call with Rochelle tonight and explained the entire situation to her. I confirmed that I totally support her, but she really has to address the ingrained and somewhat ossified culture of the CDC. I particularly pointed out to her that she just cannot hold back information from Jeff and the White House team because she is waiting for her team to finalize data. If she has preliminary data she needs to tell us about it since we may need to talk about policy that would depend on such data. She just cannot give us an MMWR on the same day that is coming out. The last time this happened she said she could not give it to us because it was “under embargo “. I pointed out to her that this enraged Jeff since the CDC owns MMWR and as director of CDC she needs to realize that no one is trying to influence what goes into MMWR but it is important that she does not surprise Jeff or the president with something that she knows and that we do not know. I love Rochelle and she knows that. I explained to her what she needs to do to make things right with Jeff . A human explained to her the story from years ago when I saved Tom Frieden from getting fired by Sylvia Burwell because of how he messed up the ebola situation as a result of his listening to “his guys “. I believe that Rochelle gets it and will survive this very difficult time. I support her totally. PRESS: WJXX -Jacksonville TV; Bloomberg TV interview – Madison Mills; 1 hour with USA Today Editorial Board; Zoom Call with Michael Spector for his adio-book; MSNBC peacock TV with Joshua Johnson August 7, 2021 The surge continues: Governor DeSantis is a complete disgrace. He is blocking the local authorities from mandating masks in various locations including schools. He is doing this while at the same time Florida is virtually on fire with surging cases. Approximately 20% of all the cases in the country right now are in Florida. When you add Florida with Texas you get about 40% of all the cases in the country. At the same time he together with his Greek chorus of Rand Paul and other GOP members of Congress together with all of the stooges at Fox News (Carlson, Hannity, Ingraham), continues to actively criticize me and talk virtually every day about my being wrong on everything I say and then I should be fired. This is an obviously calculated plan of disparaging me and any other scientists (but focusing heavily on me) that speak up against their crazy strategy. I am convinced even more that this is part of the total dystopia going on in certain elements of the country and it is all linked to “The Big Lie” involving the election and the denial of January 6. I really am worried more about the country then about myself since if this goes on I fear that our democracy is in dire danger. We had an important conversation today with Glenda Gray and Linda-Gail Bekker of the Republic of South Africa. The discussion centered around the fact that Glenda and Linda GAIL want to do a randomized placebo-controlled trial using the Moderna M RNA. The purpose of the study is to determine if and how well mRNA vaccine works in persons with HIV. We have a real problem with doing a randomized placebo-controlled trial and so we got on the phone with David Kessler, the people from NIAID including Cliff, John Mascola, Mary Maravich, Carl D., and others. I came up with a solution that everyone liked. That was to do a trial where each arm gets a prime in boost dose of Moderna and then one group gets randomized to placebo and the other group gets randomized to a third dose boost. This will kill two birds with one stone. It will avoid the controversial use of a placebo and at the same time tell you whether the mRNA vaccine works in persons with HIV and whether and whether or not they need a boost for optimal response. August 8, 2021 – Global USA PRESS: CNN “GPS” with Fareed Zakaria; NBC “Meet the Press” with Chuck Todd August 9, 2021 – Global USA Cases 140,000 yesterday. It seems that my prediction of 200,000/day will come true unfortunately. We're having continual and difficult discussions concerning boosters. With my strong persuasion we have now finally arrived to the reality that we must give an additional dose to immunocompromised people as quickly as possible. The real issue that we are struggling with is when how and to whom we should give boosters among the population in general. Clearly, we want to stagger it so that we don't have rush to the gate. We're trying to get as much data as possible to validate a decision to start giving it to the elderly at approximately 8 months following their initial vaccination. I continue to struggle with having to defend the CDC against reasonable concern about the fact that they are generally behind the curve when it comes to accumulating data that would inform proper public health action. He gets back to previous conversations that we had concerning the entrenched culture at CDC who feel that they know best and they are not accountable to anyone. Under non pandemic conditions this goes un-noticed. However, in the middle of an outbreak of this proportion it is a glaring deficit. PRESS: Black News Channel (TV); Hugh Hewitt Radio; Navajo Times Interview; BBC World News TV August 10, 2021 - Global USA The soaring of cases continue. It is really looking rather ominous in that there have been numerous reports of gatherings of completely vaccinated people in a moderate to small sized party 20 thirty 40 people where you have outbreak of infections among these individuals. It is very clear that this virus is very different in its ability to transmit compared to the alpha variant. There have been a number of discussions regarding the use of additional booster shots. I have been a strong proponent and have led the discussion in getting additional booster doses to the people who are immunosuppressed, and to get these doses to them imminently. We have had several meetings with Jeff and the team and in some cases with the FDA to try and expedite this. It becomes an issue of the clinical data in a somewhat preliminary form balanced against the need of the FDA to have firm data before they modify the EUA. The tension between Jeff and the CDC continues in that the culture does not allow the CDC to share data in real time in a situation in which you actually need data in real time to make a decision. The lack of confidence in Rochelle and the rest of the CDC is manifested by the fact that Jeff is having me as opposed to Rochelle brief the President about things that appear to be strictly epidemiological. The same holds true for briefings of the principles and the governors. I don't know what to do to help Rochelle change the culture of the CDC because this is a decades-long problem. Vivek is in total agreement with me on this issue. I met with the President today in the state dining room of the White House to discuss together with the administrator of FEMA Deanne Criswell and Assistant to the POTUS for Homeland Security Liz Sherwood-Randall among others and together with Natalie and Jeff. The topic of the discussion was how we were going to handle the obvious heavy hurricane season that is approaching in the context of major outbreaks of COVID in the gulf states that have the lowest levels of vaccination and the highest levels of infection. I presented the epidemiology data and Liz and Deanne presented the hurricane data. My impression was that the president was not particularly happy with Deanne’s presentations since she was not able to give him the answer to a lot of his questions. Nonetheless being the gentleman that he is he did not really act annoyed with her although as I get to know his body language better I could sense that he was disappointed. As indicated above David Kessler and I and most recently with the support of Jeff have been trying to push the concept of getting the US government to make a major investment in Lonza company that makes the mRNA four Moderna. We're making some progress in the implementation of the concept of the US government bankrolling Lonza to expand this capability to supply billions of doses of vaccine to the developing world. We had been working on this in collaboration with Peter Staley, James Krellenstein, and David Barr. Unfortunately, Peter in his enthusiasm to get things done quickly, orchestrated a letter signed by 175 public health advocates essentially criticizing the Biden administration for acting too slowly in getting vaccine to the developing world. They sent the letter to the president simultaneously with sending it to the Washington Post and my media friends Yasmeen Abutaleb and Dan Diamond wrote an article in the Post indicating that David Kessler and I were working with them to get the higher ups in the administration to agree with the plan but that we had not been successful. Unfortunately, this may have blown our entire plan of getting this done under the radar screen. It is likely that this could now interfere with what David and I were trying to do. Yasmeen called several times for an interview; however, I did not see any purpose in getting involved in this controversial issue and also she had already written the story. See below: Wpost: ‘Act now’ on global vaccines to stop more-dangerous variants, experts warn Biden Vivek called me tonight after resume call with Dawn O'Connell and told me that a number of scientists and public health people that were originally on the advisory committee to Biden's election group we're writing to Ron Klain urging the administration to fire Rochelle Walensky as the CDC director. I believe this is very unfair since after I have spoken to her she is really trying very hard to gain control of the agency and to change there are somewhat ossified culture. PRESS: MSNBC “Morning Joe” with Mika Brzezinski; Did Instagram and TikTok interviews with “influencers” including Actor Edgar Ramirez, Kathleen Barnes, Jax James, Merrick Hanna Chris Olsen/Ian Paget, Wisdom Kaye August 11, 2021 David Kessler is pissed at Peter Staley. David feels betrayed that Peter mentioned his name and my name in his interview with Yasmeen. Last night I called up Courtney Rowe and had a long about the pros and cons of responding to Yasmeen who has been trying to get a comment from me regarding the article. We came to the conclusion that it would not do any good since the quote could be misinterpreted. I agree with Courtney. However we may have a problem that the article may set us back in getting jeff's support to push for billions of dollars to expand capacity to be directed 2 low and middle income countries. I will try to repair any damage that has been done to this effort. I had a good conversation with Peter this morning and I believe Peter realizes that he may had done some damage by mentioning my name and David's name in his interview with Yasmeen. It is again a delicate balance of trying to get an activist-driven push to get the right thing done and still operate within the system that alone has the capability of getting the right thing done with all of the political sensitivities involved. Email from David Barr to David Kessler: From: David Barr <davidbarr376@gmail.com> Sent: Wednesday, August 11, 2021 8:47 AM To: Kessler, David (HHS/IOS) <David.Kessler@hhs.gov>; Fauci, Anthony (NIH/NIAID) [E] <afauci@niaid.nih.gov> Subject: Follow up from the Washington Post story David - I saw your message to Peter. I think you have every reason to be annoyed at Peter's quote in the story. The story is about the sign-on letter that was developed as an outcome of a meeting sponsored by Yale School of Public Health, PrEP4All, ICAP at Columbia and AVAC, in which Peter was not involved. The letter is focused on the proposed plan to scale up mRNA vaccine manufacturing, a plan that has been public for many months now. The letter has nothing to do with the discussions we've been having with you and Tony and there was no reason whatsoever for Peter to have mentioned those discussions to the reporter. I don't see the quote as revealing any detailed information, but I do see how just saying publicly that we've been talking could undermine your negotiations. I've let Peter know that I'm not happy about this. I feel that you've worked with us in good faith and are making progress as evidenced by our last call. I hope we can keep these discussions going forward. Our goal is to ensure that vaccines are available to the world as quickly as possible. I know you share our concerns and understand the urgent need for this. I do not envy your current role in all this, as it must be both exhausting and frustrating. I remain confused as to why the President and the global public health establishment do not seem to truly share our concerns. Rather than lengthy negotiations with Moderna, why hasn't Biden hauled them into the Oval Office and said 'this is what is going to happen'? Instead of a piecemeal structure based on donations, why hasn't the WHO called for wartime footing to solve this problem? Meanwhile, the caseload grows and the potential for a new variant grows with it. Again, thanks for your efforts to date and I very much hope we can continue our discussions. David POTUS called me up today. Jeff is giving the president a briefing about a number of things and he wanted me to specifically brief him about the importance of giving a third dose of vaccine to immune compromised people. Jeff felt that it was not worth my going all the way down to the White House again since I was there yesterday and so he arranged in the middle of the meeting that he was having with the president to have the president call me on my cell phone and have me explained to him the rationale of the third dose , namely a booster, to immune compromised people since they never had an adequate immune response to begin with. The confusion that the president might have is to distinguish the boost for the immune compromised versus a boost for those who overtime have an attenuation of their response even though they are immunologically normal. It was for this reason that Jeff wanted me to do the explaining. I believe that the president understood what I was saying. Just to note that almost without exception every week I brief the Principals together with Jeff, Natalie, and Rochelle. the principles consist of cabinet secretaries as well as other high ranking White House officials. I don't report on it every week but it essentially occurs every week. Today I briefed them on various aspects of the delta variant. I did a favor for the State Department today by answering a series of Qs and As about the mRNA vaccines PRESS: CNN International with Christiane Amanpour; ABC World News Tonight and ABC Evening News; podcast – “America Dissected” with Dr. Abdul El-Sayed Borowitz satire report in the New Yorker: New Yorker: Fauci Says It Is Safe to Watch YouTube Now That Rand Paul Has Been Suspended August 12, 2021 – Global USA Now averaging (7 day) >100,000 cases per day Hospitaliations in children increasing per 100,000 population Had a good call with Hans Kluge, WHO Regional Director of Europe. Good discussion about mutual interests concerning COVID-19 and issues such as vaccine hesitancy. Had a very important Zoom with Chris Whitty and Patrick Valance see above) from the UK. Jeff has suggested that I call up Chris and Patrick and ask them what the strategy is in the UK regarding booster shots. To my surprise, I found out that they have not yet implemented booster shots for the immune compromised. They plan to do that in September. However, the bigger surprise was that although they are planning to give booster shots to the elderly starting with those who are 70 years old and older and then moving to the 60 years old and older, they will not boost anyone less than 50 years old . This means that they have no intention of boosting the general population who are not immune suppressed. Of note, this is consistent with their strategy that they care less about transmission of virus among individuals than they do about keeping people out of the hospital . That's why they feel that although the general population might have a decrease in effectiveness of the vaccines leading to infection and transmission, they are not concerned since the protection against severe disease is holding strong. This is consistent with their strategy of not wearing a mask and sending the children back to school without masks. In other words, they feel that we will have to live with transmission of the virus so long as we protect people from getting severe enough disease to be hospitalized. Jeff and president Biden were concerned that we would be behind other countries in protecting our citizens when in fact we are ahead of them, certainly ahead of the UK. PRESS: White House Press Conference; ABC “Good Morning America” with Amy Robach; NBC “Today” with Craig Melvin; CBS “This Morning” with Vladmir Duthiers; ABC “World News Tonight” with David Muir; NBC “Nightly News” with Lester Holt; PBS “NewsHour” with William Brangham; KMBC (ABC) TV – Kansas City, MO with Mike Mahoney; KDFW TV (FOX) Dallas-Fort Worth with Steven Dial; WPLG TV (ABC) Miami with Ben Kennedy; Univision TV with Lourdes del Rio; Telemundo National TV with Jose Diaz-Balart; Univision Atlanta TV with Rafael Olavarria; MSNBC “The Reid Out” with Joy Reid; CNN AC/360 with Anderson Cooper; August 13, 2021 Cases continue to surge We had multiple zoom calls and conversations today concerning the proper approach to his booster vaccinations. In addition, based on this submission to the FDA on data in diminished response in the immune compromised, the ACIP recommended that people who are immune compromised including transplant patients, cancer patients on chemotherapy, any patients on severe immunosuppressive therapy, people with advanced HIV disease, and people with primary immune deficiencies receive a booster dose. We also had considerable conversations about the best way to roll out the recommendations to boost the entire population in an orderly fashion starting likely sometime in mid to late September. The COVID team agrees that this is the way to go; however, it must be done within the context of the FDA regulatory framework. I am pushing my people who are doing clinical trials on booster doses to get data as quickly as possible to the FDA and the CDC so that they can analyze it for the purpose of making policy. Jeff is very sensitive to the fact that he does not want us to look like we have come in too late to the boosting game. This is actually not the case since as mentioned above , if anything, the UK is actually behind us. There will certainly be international concern by the fact that we in the USA are giving boosts to otherwise healthy people while the rest of the world is lacking even their first boost . However, the argument that I am giving is that the USA is donating more doses and money two international vaccines for low and middle income countries then the entire rest of the world combined . At this point we have contracted for 500 million doses to be distributed in the following cadence: 200 million doses by the end of 2021 and 300 million doses before the first half of 2022 ends . In addition, we have already given away 110 million doses to 60 countries. This includes 80 million of our own doses. In addition, the USA has either given or pledged $4 billion to COVax. There is an interesting concept that is heavily debated among us. Although we all agree that we need to do as described above, we are not fully appreciative of what the decrease in incidents of infection actually means if the current rate of hospitalization and death appears to remain stable. Are we vaccinating people with a boost because we feel that ultimately those increases in infection will lead to increases in hospitalization and deaths, or are we concerned that even if vaccinated people get infected and spread the infection that we are trying to suppress transmission in addition to serious disease. Stay tuned for how this all rolls out. PRESS: WTOP with JJ Green; Twitter responses with WH Digital team; CBS Radio Los Angeles; CBS Radio NYC; White House twitter with digital team; August 14, 2021 – Global - USA – 36,300,000/618,600 140,000 cases in the USA today. We had continued discussions today with Jeff and David Kessler as to how we are going to deal with the activists (Peter Staley et al) in our attempts to cooperate with them in getting doses to the developing world. We need to get them to understand that we are with them and trying to expand the number of doses we give ; However, they need to understand that we have already given more than the entire world combined. So they really need to recognize that we've done a lot at the same time that they work with us to do even more rather than attacking us for not doing enough. Moderna has not acted in good faith. They have actually put in their patent application and have explicitly said that Barney Graham, John Mascola, and Kizzy Corbett are not inventors of the M RNA 1273 patent. This is absolutely outrageous and I have had conversations with Francis Collins, Larry Tabak, and earlier this evening with Jeff indicating that we have to get a heavy hitting law firm to argue our case. I suggested as did Jeff that we employ the firm of Williams/Connelly to represent us. We are planning to roll out next week the program of giving a booster shot to everyone starting with those in long term care facilities and the elderly, but ultimately including everyone related to their anniversary date of their last shot. Clearly, we will get both praise and criticism for this. August 15, 2021 (Sunday) Heat wave throughout the country. I had a very intensive day with the medical team trying to fashion to coherent message to justify the announcement that we plan to make this week that we will be giving a booster shot to everyone who wants one regardless of age or underlying condition. This has been a very difficult situation since the data for diminution of efficacy regarding hospitalization and death are unclear because of the confounding variables of some studies dominated by delta , some studies dominated by alpha , and some studies with a combination of both. In addition, when we talk about hospitalizations , it is unclear from several of the studies whether those who were hospitalized were almost exclusively the elderly and /or people with underlying conditions. Jeff is bent on having a coherent sharp message about this when in fact that is very difficult to do given the paucity of data. If we are too precise we will be called out because we cannot back it with data. If we are general, Jeff feels that the public will be confused. I am trying to convince him that it is OK to say that we do not know nor do we have all of the data to make a decision and sometimes you have to make a clinical or public health decision just based on clinical judgment. In this case the judgment is that delta is a very bad virus and even though we don't have firm data yet that younger people are getting seriously ill, we don't want to be late to the game. I used the metaphor of Wayne Gretzky who always said it is important to skate where the puck will be rather than where the puck is. We do not wait until younger people start requiring hospitalizations before we decide that we want to give them a boost. My job in all of this is to give the immunological basis for providing a boost. Bottom line is that the controversy will be not that we need to give a boost, but do we really need to give it to everyone instead of just to the elderly and those who have underlying conditions. One of the most important aspects about all of this is that when you boost someone with a third dose at about six months or so after the original prime boost the level of antibody goes dramatically high and I believe that this would provide durable protection against delta and any other variants that come along. My concern is that the Medical Group will not articulate this concept well enough and I will have to be out there trying to pick up the pieces as is usually the case. Summary of what has been going on hat I might not have had he time to document. I am more and more astounded by the fact that our society is so dystopic in that untruth and out and out lies seemed to win the day . In addition, I am concerned that even good scientists playing a game of using their longstanding concern with gain of function to call attention to this by what is going on regarding the argument about the origin of the virus. There is no question in my mind based on so many factors including history, molecular makeup with the virus, among others that this virus naturally emerged from an animal reservoir. Yet , people like David Relman and others are not realizing that by their focusing on the gain of function which they believe is what we funded at Wuhan could possibly be the cause of SARS Co V2 when in fact they know that this is molecularly impossible. I have evolved into something that would have been unimaginable to me just a few years ago. There are some positive aspects to it ; However, for the most part I feel like it is no longer me. I am now probably one of the most recognizable faces in the world. Millions of people idolize me and the far right radical group absolutely hate me. I cannot go out in public to a restaurant or even walk through a crowd since someone immediately recognizes me and wants to take a picture or congratulate me or just say that they said hi to me. This is driving my security group crazy as they are afraid fair among these legions of admirers will be someone who wants to kill me. All of this together with the stress associated with the fact that the president and others in the administration rely heavily on me four major decisions and I have very little staff relatively speaking who could help me. PRESS: CBS “Face the Nation” with Nancy Cordes AUGUST 16, 2021 Pediatric hospitalizations surging: Someone leaked our plan for boosters. The press are texting me all evening. I am not answering. PRESS: August 17, 2021 There is a lot going on and a lot of moving parts. We have been working very hard on trying to get a plan and a program out to deliver third boost shots to people who have received the original two dose vaccine regimen for M RNA. This is a complicated issue because it appears that the vaccines in the United states as well as globally particularly in places like Israel and England among others are still holding strong and preventing hospitalization and deaths but there is a dramatic diminution with the delta variant in protection against infection and symptomatic disease. There is an inkling that we are starting to see increase in hospitalizations particularly in Israel in vaccinated people. Jeff together with the White House team has been working on a plan to be implemented starting September the 20th to get a third shot to everyone in a cadence beginning with those who originally had received the vaccine first. These people are fundamentally health care workers, the elderly, and people in long term care facilities and nursing homes. The problem is the data that definitively show that we are seeing an increase in hospitalizations with delta are not there yet. However , as I and others know from experience , when you are dealing with COVID-19 , particularly the delta variant, you may be behind the curve by a few weeks at the time you realize you were behind the curve. I use the analogy of skating to where the puck will be not where it is now . In this regard, there will be criticisms that we acted too soon particularly since so many people around the world have not yet received any vaccine. This is countered by the fact that the United states is doing more than the rest of the world combined to get vaccine to lower middle income countries. There is an additional complicating issue here in that Jeff is insisting that when we announced this, it looks like it is a done deal and we are definitely going to do this . However, it really does depend on or authorization from the FDA together with recommendation from the CDC via advice from the ACIP. If we come out and definitively say we're going to do it prior to the FDA approval , it looks like we have politically influencing the FDA. I am warning Jeff about this because even though he is trying to do the right thing , we have to be careful that we don't look like we are tipping the scales and overriding the FDA. Janet Woodcock is very concerned about this and I do not blame her. Another complicating issue is that last night someone leaked our plan to the press and although we are going to make the announcement tomorrow the press is running wild with speculations and partial data right now. I have not answered any press calls because I do not want to get involved invalidating the breaking of a very strict code of silence. Shame on the person or persons who leaked this period now we have to explain things without necessarily giving everybody all the necessary information. In addition , we have faced with the usual problem of the CDC not giving us all the information that we need and even continuing to refer two embargoed MMWR papers to come out. We absolutely need to see those data if we are going to defend our policy. Email that I sent to Ian Sams: From: Fauci, Anthony (NIH/NIAID) [E] <afauci@niaid.nih.gov> Sent: Tuesday, August 17, 2021 2:02 PM To: Sams, Ian (HHS/ASPA) <Ian.Sams@hhs.gov>; Kessler, David (HHS/IOS) <David.Kessler@hhs.gov>; Murthy, Vivek (HHS/OASH) <Vivek.Murthy@hhs.gov>; Collins, Francis (NIH/OD) [E] <collinsf@od.nih.gov>; Walensky, Rochelle (CDC/OD) <aux7@cdc.gov>; Levine, Rachel (HHS/OASH) <Rachel.Levine@hhs.gov>; Nunez-Smith, Marcella (OS/ASPR/IO) (CTR) <Marcella.NunezSmith@hhs.gov> Cc: Phillips, Alexandria (HHS/OASH) <Alexandria.Phillips@hhs.gov>; Perry, Sherice (OS/IEA) <Sherice.Perry@hhs.gov> Subject: RE: Latest statement + Tough QA Thanks, Ian. The following that is in the statement is a very important part of the statement. Please make sure that it does not disappear. “…once FDA conducts an independent evaluation and determination of the safety and effectiveness of a third dose of the Pfizer and Moderna mRNA vaccines and CDC’s Advisory Committee on Immunization Practices (ACIP) issues formal recommendations.” Best, Tony Anthony S. Fauci, MD Director National Institute of Allergy and Infectious Diseases Building 31, Room 7A-03 31 Center Drive, MSC 2520 National Institutes of Health Bethesda, MD 20892-2520 Phone: (301) 496-2263 FAX: (301) 496-4409 E-mail: afauci@niaid.nih.gov I called Janet Woodcock to encourage her to stick by her guns and do the FDA work quickly but by the books. She is even concerned that some FDA whistleblower will tell the press that FDA is being “pressured”. Despite the fact that the leak has made things very complicated , we are putting the finishing touches on our plan for the rollout of the booster statement tomorrow. After that I will brief the president. This should be interesting since he cannot be in a good mood given the total disaster that has gone on with the withdrawal from Afghanistan and the complete takeover by the Taliban. I had an incredible and stressful evening tonight on the phone multiple times with Jeff and Rochelle and then later with John Mascola. Poor Rochelle! She had been telling all along to Jeff that the acip would go along with what we are doing. Jeff wrote a speech for the president that definitively said what we are doing. Now that the leak has occurred the acip is furious that we have already decided what we want to do without even consulting them. Jeff is being very rigid in getting a very clear crisp message of what the plan is and when Rochelle heard that Natalie had asked her to put together a schedule of how to roll out the plan, she panicked since this would actually pushed the acip over the line that they are being treated as a rubber stamp. I called up Jeff and explained to him that we really need to pull back on the schedule issue . After much discussion in which he got very agitated , but maintained his friendship and respect for me we decided to call up Rochelle and Vivek and have a zoom conversation. He was furious with her because he said that she kept on telling him that she had the acip in total alignment with what we're doing and now all of a sudden the acip is a problem. I believe that her job is in danger. I spent a lot of time on the phone trying to get Jeff to appreciate that we have got to stay within the process of how recommendations are made and that we can do that at the same time ultimately doing what we feel is right. I finally got him to listen to me and I had him change some wording in the president's speech for tomorrow that would add a degree of flexibility to the fact that we will ultimately get done what we want to do but that we would tip our hat to the recommendations of the acip. After it was all over and at 10:15 PM Jeff called me up again to see what my thoughts were. He had changed the POTUS comments to include the caveat that the details are dependent on FDA approval and recommendations from the CDC’s advisors. He was considerably calmed down and I went step by step with him and told him that we likely will be able to pull this off and get it right without having the rest of the world think we were railroading the acip which really was not what we wanted to do. He seemed OK with that. At the end of the day, after the BLA, people and physicians will boost whoever they want to boos whenever they want to. PRESS: PBS South Florida TV; National Association of Black Journalists – Interview of me and Cameron Webb by Dr. Ian Smith (Physician/journalist/author) August 18, 2021 – Global - 208,500,000/4,400,000; USA – 37,100,000/621,300 Yesterday 180,000 cases. 7 day daily average >100,000 Had a very eventful and stressful day today; however things worked out well with the rollout of the booster plan at the White House press conference. Following that I briefed the president and VP in the Oval Office together with Vivek, Jeff, Rochelle, Berchara, and Marcella, and Natalie. Only Vivek and I in person. The president and vice president asked good questions , particularly with regard to the president's concern that this is contingent upon FDA and acip recommendations . He picked up right away on the concern that Jeff had that we needed to do this and make sure that we don't have a stumbling block with the FDA and acip. The one issue that could arise is that the FDA may feel that the risk benefit ratio of boosting young kids 18 years old and there abouts may not be favorable in the context of the risk of myocarditis balanced against the risk of their winding up in the hospital as a result of COVID. The president is having a bad few days given what is going on in Afghanistan with the Taliban having taken over the country in just a couple of days following withdrawal of USA troops. As expected the response to the rollout of the booster plan was very mixed, and quite understandably. The CDC messaging all along has been dysfunctional . I do not think that this is the fault of Rochelle, but just the function of the culture at CDC where they hang on to data without letting anybody know about it until it's ready to be published. We had another instance where Rochelle was very reticent to show any of the medical team what was in the upcoming MMWRs that actually impact greatly the booster roll out because in typical fashion it was “embargoed “. One cannot imagine how ridiculous this is that a public health agency is acting like an academic department in a Medical Center where the most important thing is publishing data as opposed to guiding public health decisions. I take this opportunity now to talk about it , but this has been a chronic problem literally for the decades that I have been the NEWS CLIPPING — WASHINGTON POST — CONDENSED (1 SOURCE PAGE) “director of NIAID. Of note, Yasmeen Abutaleb wrote an article this morning in the Washington Post in which she described this exact problem. (see below). Getting back do the concept of boosters, it is very…” Fears over rising illness and death Washington Post: from the delta variant fuel Biden administration push for boosters Health officials expected to announce recommendation Wednesday that Americans get extra shots By Tyler Pager, Laurie McGinley, Dan Diamond and Lena H. Sun August 19, 2021 – Global USA Cases recently >200,000/day weekly average >100,000 I just had a good conversation, my first conversation with New York State Lieutenant governor Kathy Hochul. Starting on Monday August 23rd she will be the governor of New York State replacing Andrew Cuomo who resigned affective August 23rd related to the sexual harassment scandal in which he was involved. The conversation with Kathy was very positive and she is very interested in working very closely with me and getting advice from me regarding how New York State should handle the explosive outbreak of the delta variant. Much press (see below) regarding the announcement yesterday on booster shots. I received an email late in the evening from Elizabeth Alexander the communications director for the first lady Jill Biden. She wanted me to edit an opinion piece that the first lady was writing for Time magazine . I spent about an hour late at night doing it for her.sorry one second PRESS: Another hour long TikTok/Instagram session with young “influencers” who amazingly have millions of followers; did 6 Regional TV hits at request of the White House: WSVN Miami with Lynn Martinez; WTVT Tampa with Craig Patrick; WTMJ Milwaukee with Charles benson; DBI Radio with Rene Miller; Univision (National) with Janet Rodriguez; Telemundo (National) Lourdes….; MSNBC with Andrea Mitchell; CNBC “Closing Bell” with Sara Eisen and Wilfred Frost; CNN with Jake Tapper; August 20, 2021 Cases still increasing: I had a conversation today with the Minister of Health of Gabon – Dr. Guy Patrick Obiang Ndong. The purpose of the meeting was for me to give him an idea of how we handle COVID in the United states and to answer some of his questions particularly around the area of misinformation and disinformation that has led to vaccine hesitancy which as it turns out is a major problem in southern Africa including his own country. We had a good conversation moderated by Ms. Anne Soy, a journalist from BBC. The MOH did not mention it but I'm sure there is this feeling of concern that we are planning to give out third shot boosts at the same time that Africa has very very little vaccine. I have explained on several of the TV shows and imprint that the USA has already given more doses to LMICs then the entire rest of the world combined (see above). In addition, we plan to give hundreds of millions more and they are also working with Peter Staley and the activists to provide major increases of doses to the rest of the world (see below ). There is still ongoing controversy among some people regarding whether the idea about giving a boost was justified by the data. I had a good conversation with Paul Offit who fields that we may have jumped the gun. Vincent Racaniello has written in his blog that he does not think that the boosters are justified. They are all waiting to see data regarding an increase in hospitalization as a result of delta and waning immunity. I still believe given the Israel data that boosters in their country are already showing a significant decreases in the number of breakthrough infections that we did the right thing in making our decision. In addition, those who object seemed to forget about the fact that short of hospitalizations a lot of people get seriously ill with symptoms and signs of long COVID that can be very troublesome. The boosters are safe and to put it in plain terms it can help, and it certainly cannot hurt. August 21, 2021 184,000 cases today! August 22, 2021 (Sunday) – (no shows for me today – predominantly Vivek Murthy) Had a zoom call today with Jeff and the medical team planning how we can roll out the booster situation putting all the pieces together with the FDA, the CDC, and the acip. We also heard that FISA will get it's BLA on Monday August 23rd. One of the important parts of the discussion was my relating data that we have received from the Minister of Health of Israel. The data clearly show that hospitalizations for people with two doses of vaccine are going up significantly particularly among the elderly and those with underlying conditions . In addition, they are showing that the efficacy of two doses against infection and symptomatic disease has dramatically diminished, and when you give the third dose boost, this turns it around dramatically and diminishes the breakthrough infections. These data are well ahead of the somewhat disjointed data from the CDC. However what it does do is_that we are correct in asking for boosters essentially for everyone. In addition, I am going to pursue with calls to Peter Staley and others (Krellenstein and Barr) as well as a follow up call with Jeff , David Kessler, and me to plan a more coherent strategy about getting doses led by the United states to the rest of the world. The plan to do this would be to increase dramatically the production capacity of the companies particularly moderna even if we have to deal with Lonza directly since Lonza is a major multilocation company that is producing the vaccine for Moderna. Stay tuned. In a follow up conversation with Jeff and David Kessler, Jeff was amenable to pursuing the plan of Peter and the activist group ; however, he wanted to make sure that we got the situation with the Moderna booster straight before we started to go to war with Moderna to get them to cooperate with us on the Lonza deal. I believe that Jeff is serious about this and we may in fact go that route once we get the approvals to use moderna as part of the booster plan. In this regard, Tom Frieden call me up tonight urging me to push ahead with the “nuclear option “a forcing moderna to cooperate in expanding capacity for the developing world. Tom feels that moderna or a bunch of used car salesman and he does not trust them at all. He has stated , which is partially true, that they would be nothing without the NIH and the federal government. In this regard, Beth Cameron from NSC wanted me to look over a summit plan for addressing the global issue of COVID. I wrote back to her and emphasized that I feel strongly that the United states should take a PEPFAR-type approach in assuming any leadership role in getting doses to low and middle income countries. The Israeli data are emerging as extremely important since it is clear , as they are about a month and a half ahead of us and everything, that the vaccine efficacy is diminishing significantly overtime against infection and symptomatic disease. However, unlike the situation here in the USA, the Israelis are starting to see a diminution in protection against hospitalization and death. This is exactly what we have predicted in our decision to move ahead with the booster program. Furthermore, the Israelis are starting to see a very positive effect following giving boosters to over 1,000,000 people in the sense that the number of infections have dramatically diminished in association with the administration of the boosters. August 23, 2021 – Global USA BLA granted for Pfizer by the FDA!! I just did a site visit to the Department of State facility that does the screening for diplomatic pouches and mail. This is the facility that has been screening my mail ever since I had the anthrax scare with the power in one of my letters literally one year ago four days from now. Brett Rowland arrange for me to go there to thank the people in the facility and to encourage them in their work. They were very grateful but I took the time to visit them and there was the usual selfies galore. Another important issue today was that we were told by Larry Tabak at the state department wanted us to remove any names of people in Afghanistan that we are interacting with through grants or contracts from our public facing databases and websites. The reason for this is that we are concerned that the Taliban will use the websites to identify people in Afghanistan with connections to the United states and would then assassinate them. It is very clear that things are not going well following the withdrawal of U.S. troops from Afghanistan. The Taliban has easily taken over the country and now we are having trouble getting Americans as well as Afghanistan allies such as interpreters out of Kabul safely. It's a very bad time for the Biden administration since they are being severely criticized for not having the right intelligence capability to indicate to them that the Taliban would take over so quickly without allowing time for us to withdraw our own personnel in an orderly fashion. What we did was withdraw the military first thinking that we would have ample time to withdraw diplomats and other personnel safely . Obviously this is not the case and it is still a very tenuous situation in Afghanistan. PRESS: Podcast 70 Over 70; NPR “All Things Considered” with Mary Louise Kelly; Podcast “A Starting Point” with Mark Kassen and Chris Evans; PBS ”NewsHour” with Judy Woodruff; MSNBC “Peacock” with Mehdi Hasan; August 24, 2021 – Global USA Cases, hospitalizations and deaths (to a lesser extent) continue to soar. More conspiracy theory like letters keep coming in from congressmen and senators trying to link us to the origin of COVID-19. This is an amazing and unbelievable waste of our time and has no bearing whatsoever on what we have actually done with that minor, minor $125,000 grant to the Wuhan institute of virology. It is totally mind boggling how they are distorting the truth to try and distract from the reality of what actually had happened during the Trump administration where he lied and underplayed the outbreak. Strange but not surprising thing happened as a result of several of the shows that I was on over the last 24 hours. On several of the TV shows I was talking mostly about the favorable aspect of the final approval of the BLA for Pfizer. However, in one of the conversations someone asked when I thought we were to get back to normal. I gave the usual caveats but then went on to say if we get as many people vaccinated as we possibly can as quickly as we possibly can we could diminish the number of cases and if we get through the winter which will be complicated by influenza and other respiratory infections, then I believe we could get back to some form of real normality by the spring of 2022. Much to my surprise I got a call this morning from Jeff clearly upset because the news media had jumped on that and said that Biden has been saying we're going to get out of this soon and Fauci who knows what's going on is saying it's going to be into next year. I am getting a little bit concerned, even though I understand Jeff's concern about the distortion of a message for a political purpose, that we may be tailoring a message that is not totally aligned with the truth. In fact, I believe we would be very lucky if we're back to normal by the spring of 2022. I told Jeff that from now on when asked to predict I will just say we don't know. This might actually not go over very well with the press anyway, but that is what I will say. Of note shortly after my call with Jeff, Courtney Rowe called me up in a much more conciliatory manner saying she understands how these things get taken out of context and said that she heard it a lot more the way I meant it; however, we really need to be careful that people would be distorting our message. I agree with her. PRESS: CBS “This Morning” with Gayle King; NBC “Today”; MSNBC “Morning Joe”; Telemundo TV Hoy Dia with Adamari Lopez; August 25, 2021 – Global USA Cases continue > 120,000/day Had an extremely interesting Zoom meeting yesterday with the Israeli Minister of Health and several Israeli scientists. The Israelis have always been about a month or so ahead of the USA temporarily with regard to the dynamics of the outbreak, the percentage of population vaccinated, and their recent decision to provide booster shots as third doses first to their elderly and then to progressively younger people. On the zoom call that Danny Douek and Bob Seder helped organize since Danny spent a year sabbatical in Israel, it became clear that's what we suspected was actually true. On the call for the Israelis were: Nachman Ash, Minister of Health of Israel; Sharon Alroy-Preis – Director of Public Health Services for Israel; Ran Achitov – Senior Advisor to the Israel Prime Minister Naftali Bennett; Ron Milo – Weizmann Institute; Boaz Lev. The Israelis were seeing a gradual waning of protection of the Pfizer vaccine over a few months to the point of protection against infection and mild disease was dramatically diminished after several months. Importantly, they found that the protection against severe disease leading to hospitalization also significantly decreased. This latter point is extremely important because the data from the USA cohorts was suggesting that But did not definitively show it. In addition, they gave booster shots to about 1.6 million people and have shown that the booster shots dramatically reconstitute the protection against infection. clinical disease and hospitalization. Furthermore, they found a decrease in the Ro strongly suggesting that the booster also diminished transmission. These findings completely validate I would decision to begin giving boosters here in the United States. I briefed Jeff on this last night and we will arrange an additional call with the Israelis including John Mascola, David Kessler, and others involved in our program. PRESS: The Times of Israel: Health Ministry officials said to update Fauci on COVID booster shot campaign Today, 9:02 pm • US top infectious disease expert Dr. Anthony Fauci testifies before the Senate Health, Education, Labor, and Pensions Committee, on Capitol Hill in Washington, on July 20, 2021. (J. Scott Applewhite, Pool/AP) The Kan public broadcaster reports that top Health Ministry officials, including director-general Nachman Ash, held a virtual meeting with Dr. Anthony Fauci to discuss Israel’s COVID-19 vaccine booster shot campaign. The report says that the Israeli officials updated Fauci, who is director of the National Institute of Allergy and Infectious Diseases and US President Joe Biden’s chief medical advisor, on figures showing that the third vaccine dose provides increased protection against infection and serious morbidity. The US is planning to begin administering booster shots next month. August 26, 2021 - Global – 213,400,000/4,460,000; USA – 38,300,000/631,400 Cases still soaring The people in the White House medical team are all excited now about the Israeli data, and they want me to arrange for resume between members of our White House team and our Israeli colleagues. I would be happy to do this since I want them to appreciate the extraordinary data that the Israelis have. A science in the shadows PRESS: Washington Post: Controls on ‘gain of function’ experiments with supercharged pathogens have been undercut despite concerns about lab leaks By David Willman and Madison Muller August 27, 2021 – Global – 214,500,000/4,470,000; USA – 38,500,000/632,800 Just as a follow up over the last days to weeks - I continue to get attacked viciously by the far right social media including FOX News. they are still dancing around the inappropriate conflating of gain of function research (See Willmann article above) and the origin of the virus. I am starting to get so annoyed by this that for the first time ever I'm seriously discussing with Christine the timeline not my stepping down from this ridiculously thankless situation that I'm in . I say that still knowing that it is very unlikely that I will do that. POTUS slight mis-speak – Interesting situation arose today. We were in our pre brief for the White House presser that would take place in 1/2 an hour. In the middle of the pre brief , president Biden called me up on my cell phone. He said he was in with the Prime Minister of Israel and the Prime Minister was telling him that Israel will be giving their booster shot at five months. The president wanted to know what we were doing about that and were we following the lead of Israel. I told him that we were sticking with eight months but since the ultimate decision will be with the acip that they would likely give us the possibility of a range from six to nine months and so depending on the data, we would have the option of giving it earlier . However, for now we were sticking with eight months beginning on September the 20th. Very shortly after I said that the president got up and said that we might start boosting earlier perhaps at five months because the Israelis are doing that and he spoke to me about it. As one might imagine this created a flurry among the press and White House comms . The good news is that everybody in White House comms knew exactly what I said to the President and so it was just one of those things that the President will say what the president will say (see below). And has been wanting to get more closely involved in the data flow and information flow . In this regard, he has asked me to see if I could get him more involved in the various meetings that we have among the White House medical team . I have arranged that and we will have him join the weekly meeting that Vivek organizers among the White House docs. In addition I have arranged for him to visit NIH and sit down for a roundtable chat mostly but the people from the VRC. We did that today and it was interesting as usual since Eric is a very smart guy. PRESS: TV and Radio for local stations: Black Information Network (Radio); Rolling Out (TV); The Root (Radio); Instagram Live with Geoff Edgers (Washington Post); White House plans to clarify Biden boosters statement Caitlin Owens (Axios) August 28, 2021 (Saturday) – Zoom meetings with Jeff - There is concern about sticking with the eight month projection for the beginning of boosting. Jeff is adamant not to waver on the 8 month projection even though it is clear from the data in Israel as well as from the general knowledge that in Israel there is waning of protection as early as five months. I will be on all the Sunday shows tomorrow and I will have to walk a tightrope to stick with eight months on the one hand and leave the flexibility for earlier than eight months on the other. The intelligence community report on the origins came out and in some respects it was good news in that they felt fairly confident that it was not a bioweapon nor that it was bioengineered. They still left open the possibility that it could be a lab leak ; However, more elements of the intelligence community felt that it was a natural occurrence compared to the single component (FBI) who seemed to feel strongly that it was a lab leak , although this is based on no data at all. The reaction to the report was rather typical with Bob Garry saying that he was pleased that it ruled out bio engineering and David Relman making the incredible statement in a Nature news article that he would like to see all of the records of the NIH in their dealing with Chinese scientists. Truly amazing! There is no doubt that he has an agenda here and that is unfortunate. August 29, 2021 (Sunday) – Cases continue to surge with increases in hospitalizations as well as deaths. The cases have been between 100,000 and 150,000 for several days in a row now. Thus far the piece by David Willman has not received much attention. It has only appeared online and I expected it to be on the front page of the Sunday Washington Post and in fact it was not there it is possible that the situation in Afghanistan as well as the horror of the upcoming hurricane Ida has pushed this out of the news. I will have to navigate all of the difficult questions today since the White House is putting me out on all the Sunday shows. The boosts that the Israelis are giving or having a profoundly positive effect on deminishing the number of cases that are severe . See below: Israel: Two weeks after the third dose campaign, and for the past two weeks, there is a decrease in the fraction of cases who become seriously ill https://bit.ly/3gKS7fY PRESS: CNN “State of the Union” with Jake Tapper; ABC “This Week” with Martha Raddatz; NBC “Meet the Press” with Chuck Todd; August 30, 2021 >150,000 cases today Did podcast with American Muslim Health Professionals Jeff continues to be frustrated with Rochelle. she does not seem to have the control over her agency that Jeff would like to have her execute. He is frustrated that she doesn't tell anybody what's coming out in MMWR as if it were a private journal as opposed to what it really is - the journal of the CDC. In addition, Jeff is very concerned that she is out of touch with what goes on in the acip and in other various components that interact with the CDC. The other night I had to talk him down from feeling like he had to let her go. I continue to have faith in her and that she is a very good person but she is dealing with a rigid and secretive organization that has been that way decades before she arrived. PRESS: Sinclair TV; TikTok with influencers including Grammy Award-winner (4X) Jason Isbell; August 31, 2021 - Global -216,900,000/4,500,000; USA – 39,100,000/637,400 Trouble at the FDA. Today it was announced that Marion Gruber and Phil Krause will leave CBER at the FDA. The reason being given is that they are upset that decisions have been made by acip and by the White House that should have been made first at the level of the FDA. This has been superimposed upon the fact that the administration is having a hard time making a decision about who the next FDA commissioner will be. There is pushback from some senators particularly Joe Manchin (D-WV) against Janet Woodcock even though she should be the top candidate. The loss of Marion and Phil is a big blow to the FDA. More drama with the FDA CDC relationship. Another late night call from Larry Horowitz telling me that the CDC with Rochelle want the ACIP to discuss publicly data that might confuse the issue since the FDA has confidential data that might change the direction of the discussion. Somehow or other the CDC does not fully appreciate that traditionally their ACIP working group was allowed to discuss in private data related to a particular study, but they would not publicly discuss it until the FDA weighed in on it. As it currently is rolling out, Rochelle seems somehow influenced perhaps by Amanda Fine who is a CDC employee but who is the executive secretary of the ACIP. They want to publicly discuss data before the FDA weighs in with data that they have that is confidential. Bottom line is that if the ACIP publicly discusses incomplete data, when the FDA weighs in with the confidential data it would cause a lot of confusion. This is driving Jeff crazy and again he is on the verge of firing Rochelle. Again, Jeff is asking me to help solve the problem by speaking to Rochelle and explaining to her why it is so important to do things in the traditional format of giving the FDA the chance to make decisions about data before the ACIP ways in with recommendations concerning those data to the CDC. I called up Peter Marks last night and Peter feels that the CDC and the ACIP are breaking tradition here and Peter feels strongly that it is OK for the working groups acip to discuss data so long as they do not do so publicly before the FDA opines from a regulatory standpoint. PRESS: September 1, 2021 Global – 217,600,000/4,500,000; USA – 39,300,000/638,700 I spoke to Rochelle this AM. I tried to explain to her the dilemma that we are in with this disagreement between CDC /ACIP and the FDA where Jeff agrees that the acip should not opine before the FDA rules. Clearly, Jeff is expecting me to be the arbitrator here and fix this. Jeff is very concerned that the acip will come out with recommendations contrary to what we had already planned and what the FDA will allow and that this will make it look like we are “the gang that could not shoot straight “. Rochelle feels that we are all going to be in the same place anyway but Jeff is concerned to the contrary. Jeff asked me to broker a meeting between senior CDC and senior FDA officials to see if we can settle this dispute regarding the role of acip. PRESS: CNN “The Situation Room” with Wolf Blitzer September 2, 2021 – Global - USA - Weekly average 149,000 cases/day Important reflection about “controlling the message” - I thought I would make this comment now since it is something that has been ongoing for some time. It relates to the fact that this administration particularly in the form of Jeff does not at all want to interfere with the science or dictate what the science should be saying. This is completely different from the interference with science and the actual contradiction of science that was so rampant during the Trump administration. However, in the situation where we came out with the statements that we should begin boosters on the week of the 20th of September and at 8 months from the time individuals finish their original immunization regimen, it is clear that the timing was not totally science driven . It was logistically driven. In other words, we found out in late July that it was clear based on the hint of what we were seeing here in the United States and what the Israelis were seeing that we would need to boost. From a logistics standpoint we could not begin to do that until September which would put it eight months following the time that the first people got their vaccination in January. And so the eight month timeframe was not based on any biological or clinical science. It was based purely on logistics. And yet whenever we have a discussion Jeff insists that we stay with eight months because the science dictates that it is 8 months. That is just not true. It very well may be and in fact it looks like it should be earlier, such as six months. The reason Jeff did not want to change or veer away from 8 months is that he did not want it to seem that we were saying one thing on one day, and a week or so later we would change it, for example changing from eight months to six months. I consider this a fixation on messaging which is really unnecessary. I would have said we chose eight months because it was already eight months from the time that people got their first vaccination. Jeff was afraid that we would get criticized that we should have been doing it earlier if we switch from eight to six months. I would have said what the truth was that we picked eight months at first because that was the logistic reason and as soon as we found out that it was better to do it at six months we would then change to six months. It is the truth and there's nothing wrong with that. Important principals meeting today in the SCIF. the meeting was led by Jake Sullivan of NSC . The subject matter was how the United states could take a leadership role in the global response to the COVID-19 pandemic. Specifically, the question arose about how we can get foreign countries including China and India to participate in the process of getting doses to low and middle-income countries. A number of the principals weighed in including Samantha Powers, Tony Blinken, and others. Although I have a keen interest in this concept and I have been discussing it in detail with Jeff and with Peter Staley and David Kessler, I did not preemptively make any comments since they did not ask me to. However, in the future I will give my opinion as how we can best accomplish this goal.

Global USA Continued tension between CDC /Rochelle and Jeff concerning the rollout of the booster program. The consistent problem is the concern that Jeff has that the ACIP might come out with significant variance from what we had planned. Jeff does not want to control the science , but he clearly wants to make sure that we do not have a garbled message. Going back over this in time, Jeff wanted to get out a crisp message of what we will do with boosters because he felt that if we did not, the country would say that we were behind the curve and that we allowed people to die without getting boosted. For that reason we put out the statement that we have a plan to boost. Now among some it appears that the White House and the medical team haver gotten ahead of the science and the usual process , which actually is not the case. The National Geographic documentary “FAUCI” came out yesterday at Telluride Film Festival. I am understandably concerned that the radical right and others who hate me will consider the film self-aggrandizing. However, it is very clear that I did not solicit this film. it started off as a film about HIV driven by Janet Tobias. At the onset Glenda Gray and I were featured people in the film centered around HIV vaccines. When the producers that Janet met with saw some of the filmed material they felt that it would be better to do a film about me focusing on the concept of “The Public Servant”. When National Geographic took over, they made it a very polished documentary which was not at all a hero worship of me but was a realistic portrayal of the stress and strain and ups and downs of what I have been through with multiple outbreaks, particularly HIV and COVID. Having said that the film will likely be praised by many but also used by some to continue to attack me. Such as life. Participated in “The European House” Ambrosetti Conference in Lake Como (virtually) with panelists Kai-fu Lee, Stephane Bancel and moderated by Mariya Gabriel Difficulties setting in with the booster rollout. As I suspected it is not going to be a smooth rollout of all three companies being able to provide boosters by September the 20th. One of the key obstacles has been Moderna who is insisting on making their booster dose 50 micrograms. Given the fact that everything else has been done with 100 micrograms this will cause a delay by at least a few weeks for the rollout of the Moderna product. Therefore, this will lead to a disjointed program. Jeff is not happy, but it is what it is. PRESS: Podcast with Andy Slavitt; Canadian Broadcast TV; MSNBC with Chris Hayes September 4, 2021 – Global - USA – 39,800,000/644,800 Still a fair amount of confusion and concern about the rollout of the booster program. David Kessler comes down hard on the fact that the ACIP cannot be out of sync with the FDA. If the FDA says that boosters are OK for people 18 and older, David feels it is not appropriate for the ACIP to restrict it to 65 years of age and older. Obviously, Jeff is upset by what has gone on since this is what he has tried to avoid. September 5, 2021- Global USA Very nice thing happened tonight. Jeff called me by phone just to thank me for everything that I am doing. He read the transcripts of my appearances on the Sunday shows and wanted to tell me how grateful he was for the fact that I've been doing this for such a long time, much longer than any of the others , and he thought that it would be important for me to know that everybody appreciates what I'm doing. PRESS: CBS “Face the Nation”; CNN with Jim Acosta September 6, 2021 - Global USA Jeff brought over my house this evening the POTUS speech for Wednesday to have me check for any issues or inaccuracies. I made a few edits, but nothing substantial. September 7, 2021 – Global USA Cases averaging >150,000/day. Going back and forth with FDA (Peter Marks) about whether there will be enough safety data on young people to justify boosters for everyone. Peter is aligned with me. I feel that if the safety data holds we should definitely give boosts to everyone at every age. I do not believe that you have to show a diminution in protection against hospitalization in order to trigger a booster. No way in a clinical trial would you require hospitalization to be a primary endpoint. We need to prevent symptomatic disease in everyone as well as preventing the spread of infection. That is why we need a booster for everyone . I have said it before , and I will say it now that I feel the proper regimen for COVID-19 vaccinations should be a prime followed in four weeks by a boost followed and five to seven months buy a third shot boost. PRESS: CNN “New Day” with Jim Sciutto; NPR “Morning Edition” with Rachel Martin; La Stampa (Italian TV); New York Times Podcast with Apoorva Mandavilli September 8, 2021 I had an interesting visit today in the Oval Office with President Biden. I was there to brief him about the mu variant as well as to go over his six-point speech that he is going to be delivering tomorrow. Clearly, President Biden is troubled by getting the right message to the American people. He is concerned that people would be under the impression that we will never get out of the oppression of this pandemic. And so, he struggled with the words in his upcoming speech which I had the opportunity over the last few days to help edit. He was struggling with the issue of how we can say that the unvaccinated people or an impediment to where we want to go without discouraging the vaccinated people from feeling that even though they are vaccinated they are powerless to be able to lead a normal existence so long as the unvaccinated people are continuing to propagate the spread of the virus. I suggested to him that instead of saying that the 25% of the population that are unvaccinated are hindering the 75% of the population that are vaccinated , he should focus on the fact that the unvaccinated people are not harming the vaccinated people physically but they are preventing us from returning to a normal life which at the end of the day is a negative issue for the 75% of the population who are vaccinated. It is a complicated message, and he is struggling with it . I am convinced that he is an extremely sincere and good person who wants to do the right thing. September 9, 2021 – Global – 222,400,000/4,600,000; USA – 40,500,000/652,500 >160,000 infections today President gave his national speech today on the 6th part plan to combat the delta variant. As mentioned above I played a role and editing his speech and in discussing yet with the president himself yesterday as well as with Jeff and the White House team. PRESS: Podcast with David Rubenstein; Fireside chat with The Boston Globe; NBC Nightly News with Lester Holt; PBS NewsHour with Judy Woodruff; CNN “AC360” with Anderson Cooper;

Moderna presented to us (Medical Team + other interested parties) their data on the open label study involving the crossover from their phase three trial. Consistent with the data from Pfizer they see a waning of immunity particularly in association with the delta variant. This is another bit of data to argue for the booster program that we will soon roll out during the week of September the 20th. Had a very heated and intense Zoom discussion this evening with the medical team as well as people from CDC, FDA, and HHS - Key players among many were: Peter Marks, Janet Woodcock, Rochelle Walensky, Amanda Fine (CDC), Stephen Cha, David Kessler, Vivek Murthy, Leslie Dach, et al. The subject matter of the intense discussion was trying to align the FDA with the CDC in the interpretation of data from Israel regarding the safety and efficacy of a third shot booster dose. It is clear from the Israel data that there is waning immunity across all of the age groups not only for infection protection but also for protection against severe disease. The sticking point is that if the FDA pushes for approval of the third booster shot for all ages there is the question of a lack of a lot of data for safety among young individuals particularly in the context of myocarditis. The CDC , particularly in the person of Amanda Fine, was very concerned that the ACIP would balk at recommending for younger individuals the third dose because there was not enough safety data. As we all know Jeff is very much intense on getting this approval through. I would imagine that he would be OK with the approval now of doses down to around 30 or 40 years old with the stipulation that as soon as safety data comes in for younger people, we could approve that for all ages. We will continue the discussions over the next 24 to 36 hours. What was supposed to be 1/2 an hour meeting tonight turned out to be a 2 1/2 hour meeting. This subject is being intensely discussed throughout the community and into the media. The people who were involved in the Lancet article discussed above we're actually shooting from the hip without knowing anything about the Israeli data. It will become clear that they were completely off base as soon as the Israeli data becomes known to everyone. After the phone call I spoke to Jeff and explain what happened at the meeting. He seemed OK so long as we don't stall on the approval. PRESS: MSNBC – “Morning Joe”; ABC GMA Instagram with Tony Morrison; CNN “The Lead” with Jake Tapper; MSNBC – “All In” with Chris Hayes

Today – 155,000 cases Had my every couple of weeks Zoom call with Chris Whitty (UK). Oatrick Vallance is usually on the calls, but was not on today. We discussed a number of items including the tension around booster shots that I have described above. The UK has decided that they will give boosters to everyone 50 years of age and older as well as to their health care providers and immunocompromised. They are going to wait and observe before they go any younger than 50 years of age also they will very unlikely be vaccinating children younger than 12 years old. This is in contrast to our plans to complete the clinical trials and vaccinate two as young as six months old . It is likely that we will have enough data to vaccinate children from 11 years old to five years old by the middle to end of October into early November. PRESS: Daily Telegraph – Nick Allen -print; Instagram with Jessica Waller; YouTube with Roland Martin “Unfiltered”; WTOP Radio with Mike Murillo KLN (Kaiser Health News): How Fauci and the NIH Got Ahead of the FDA and CDC in Backing Boosters By Sarah Jane Tribble and Arthur Allen September 16, 2021 Dr. Anthony Fauci, the nation's top infectious disease expert, and Centers for Disease Control and Prevention Director Dr. Rochelle Walensky are sworn in before testifying at a House Select Subcommittee hearing on April 15. (Susan Walsh-Pool / Getty Images) In January — long before the first jabs of covid-19 vaccine were even available to most Americans — scientists working under Dr. Anthony Fauci at the National Institute of Allergy and Infectious Diseases were already thinking about potential booster shots. This story also ran on Los Angeles Times. A month later, they organized an international group of epidemiologists, virologists and biostatisticians to track and sequence covid variants. They called the elite group SAVE, or SARS-Cov-2 Variant Testing Pipeline. And by the end of March, the scientists at NIAID were experimenting with monkeys and reviewing early data from humans showing that booster shots provided a rapid increase in protective antibodies — even against dangerous variants.

Global – 232,600,000/4,800,000; USA - 43,200,000/691,500 Had a very tough and ridiculous interview with Hugh Hewitt. Hugh, who usually is a reasonable, albeit very conservative person, was extremely aggressive with me in an interview in which he kept insisting that people are not getting vaccinated because I am telling them to get vaccinated and strongly suggested that I step down and retire since I am the obstacle to people getting vaccinated. He quoted a survey saying that middle to right people want me to retire and are not getting vaccinated because I'm the messenger telling them to get vaccinated. Truly an incredible train of thought on his part. He said we need fresh faces telling people to get vaccinated and if we had fresh faces then people would get vaccinated. I countered by saying we do have fresh faces in the form of Rochelle Walensky and Vivek Murthy. And so does he consider that although all three of us are saying to get vaccinated including two new fresh faces that people are not getting vaccinated merely because I'm one of the three people telling them to get vaccinated?? I have never heard of a more distorted train of thought. This conversation triggered in me some serious thinking about several things including when I actually would want to retire from the untenable situation that I am in of having 10s of millions of people hate me because I stand for the truth. Also, this nonsense about conflating the discussion about gain of function with the lab lead theory is preposterous and totally distracting and draining of everyone’s energy. Richard Ebright with his gain of function obsession is a total asshole who is pushing this theory because he “wants to be somebody”. I am terribly disappointed with Jesse Bloom and David Relman for doing somewhat of the same thing. they have been pushing to stop any gain of function research for a long time and I believe that in some respects they are pushing for an even hoping that this was a lab leak , which the molecular analysis of the viruses that we used in the lab compared to the virus SARS-CoV-2 clearly indicate that it is molecularly impossible for the viruses under the auspices of the NIH grant to have been manipulated into or evolved into SARS-Cov-2. The opposition to me is part of the “big lie” – “Lock her up”; Trump won the election; January 6th was really a friendly visit to the Capitol; “the China virus” and Trump was correct, “Fire Fauci” since he was wrong all along and so let's discredit him, and so on. Quite frankly , I am finally coming to the realization that our democracy is truly threatened and that it is possible, even likely, that our democracy will crumble with the 2024 election. If trump wins , we are finished . If trump loses, his far right lunatics will likely try again to overthrow the election. And with the attempts to have state legislators (Republican) validate the electoral votes, I am really afraid that they might be successful. Having said all of this, there is no way that I am going to retire before this outbreak is under control. I continue to give regular interviews about every couple of months with Sheri Fink who is doing a book on COVID-19. I am trying to stay out of any Trump versus Fauci discussion and focus more on the evolution of the outbreak. Matthew Memoli is turning into a real problem. He has written an email dated July 30th to me to Hugh Auchincloss and to Cliff Lane. The long and short of it is that he feels that vaccinating people is a bad idea even though he is the major proponent of challenge studies for vaccines. He believes that by vaccinating people we will be selecting for variants which in the long run will be detrimental to the population. This is a little bit more sophisticated effort than that of Scott Atlas. He has gone further than that, however. He has released the email to congressional committees and to the press and now without a doubt he is going to be talking about the fact that even though he is a clinical center employee he will refuse to follow the vaccine mandate that soon will be implemented at the NIH. In addition, he likely will go on the media spouting this extraordinary philosophy of his. I have made it clear to everyone that we should not interfere in any way with what he is doing because without a doubt he will say that we are trying to muzzle him and that will create more of a problem than the incredible nonsense that he is spewing. It looks like we will just have to buckle down and let him proceed with his craziness and hopefully he will not do a lot of damage to our attempts to get people vaccinated. It is inconceivable to me that he actually feels that it is OK to let everybody get infected just so that we can get immunity where the virus is not selected for by vaccine induced immunity. Letting people get infected has led to 680,000 deaths in the USA thus far. How can he miss the fact that the virus circulating within people who don't get an adequate immune response will lead to variants just as easily as vaccine immunity-induced mutations. He just makes no sense at all. Matt Memoli has now gone completely rogue. He is turning into a complete Scott Atlas (see above). Not only does he think that we should not be vaccinating people, he believes that mandating is unethical because it's going to make matters worse vis-à-vis the immune response. I thought nothing could be worse than that, but now he's done something unbelievable. He has taken a speech or an interview that I gave saying that although children statistically do much, much better than adults which regard to developing severe disease there are still (given the delta variant) a significant number of children who get sick and hospitalized and in fact there are more deaths among children from COVID-19 and there are after flu. He comes out now with an email to me saying that this is untrue and that there are more deaths by far with flu rather than COVID19. In fact, he wants me to publicly retract my statement!!!! However, what he is doing is that he is looking at “estimated burden of flu” which is calculated with a model at the end of the year which is usually three times the amount of the “reported cases”. I was referring to the reported cases which are much less. And so, he seems to be out to make me look bad for reasons that I don't understand except that he is a complete contrarian. He's an infectious disease person who doesn't want to vaccinate people, who thinks mandates are unethical, and who is now telling me that I need to retract statements that I've made. He's a junior member of the institute and he is telling the institute director that I need to retract the statement based on information that he thinks is incorrect, but is correct. Unbelievable what I have to deal with! We have decided that we are not going to do anything with him; w are not going to approach him; we are not going to even talk to him about this since I know from my experience that if we do anything, he will say that we were trying to muzzle him. As far as I am concerned he could say whatever he wants to say, as crazy as it is, whatever he wants to say. Also he said that he is refusing to get vaccinated The problem with this is that the new rule from the federal government is that if he does not get vaccinated he is going to get fired unless he has a religious exemption. If it turns out that he winds up getting fired, he will almost certainly say that it is retaliation. PRESS: Hugh Hewitt radio interview; NPR Radio “Here and Now” with Tonya Mosley; MSNBC – “Reports” with Andrea Mitchell; KLZ Israeli Radio;

Global – 236,600,000/4,800,000; USA – 44,100,000/708,800 Hatred on twitter!! I have not been commenting on this in my daily notes . However, the vitriol and outright hatred towards me by the far right on Twitter is accelerating and is really extraordinary. Greg Folkers describes it as a cesspool of hate against me. This is amplified by the Fox News network who uses every opportunity particularly with Tucker Carlson, Sean Hannity, and Laura Ingraham who almost every night say something about me that is a total lie and would under other circumstances be extremely libelous. This is part of the total movement of the “big lie”. CNN with Don Lemon last night showed clips of former Vice President Pence, Minority Leader Kevin McCarthy, Minority Leader Mitch McConnell, and Lindsey Graham condemning former president trump for being the instigating force behind the January 6th insurrection and insisting that he be held responsible for this. Then Don Lemon fast-forwarded to their statements recently in which they acted like January 6th never occurred. For example, former vice president Pence said that January 6th was a creation and fabrication of the media . This is astounding that these lies can be said without blinking an eye. I am concerned in some respects about myself and my safety even though I have security. However, I am even more concerned about whether our democracy will survive. There had been some talk that countries such as the UK, EU, and Israel we're allowing people who have recovered from COVID infection to be considered as equivalent to being vaccinated and hence would be allowed to have a “green pass “. As it turns out that certainly is not the case for the UK (see above – Chris Whitty) and recently Israel has also denied that that is the case for them. However, post-infection people will need 1 dose of vaccine for a green pass. The new measure will be introduced on the same date that anyone who has not received a booster shot six months after getting a second vaccine dose will have their Green Pass revoked. There has been considerable disagreement and discussion about whether the delta variant is more severe in children compared to other variants. Certain studies showed that delta variant appears to be more serious in adults compared to other variants; however, there is disagreement about children. A recent study came out from the UK showing that severity of illness was similar in children who were infected with the alpha variant compared to the delta variant . See link below: https://www.medrxiv.org/content/10.1101/2021.10.06.21264467v1.full.pdf As booster discussions and disagreements continue, the Israeli data more and moire show that my stance on boosters is correct. For example, it is becoming clear that boosters protect against the waning immunity for infection and severe disease for individuals as young as 40 years old and not just for individuals who are 65 years of age and older . See recent paper in preprint server: Protection Across Age Groups of BNT162b2 Vaccine Booster against Covid-19 Yinon M. Bar-On*, M.Sc., Yair Goldberg*, Ph.D., Micha Mandel, Ph.D., Omri Bodenheimer, M.Sc., Laurence Freedman, Ph.D., Sharon Alroy-Preis, M.D., Nachman Ash, M.D., Amit Huppert*, Ph.D. and Ron Milo*, Ph.D. *Contributed equally Had very successful leadership forum today. Somewhat sentimental since it is Francis Collins’s last leadership forum

Sad news today!! Colin Powell passed away due to complications of COVID-19. He had been under treatment for multiple myeloma. He was vaccinated against SARS-CoV-2. He died at Walter Reed Hospital. I got to know him through social events. He was always very kind, generous and gave me advice about writing my memoir. Very likeable person. I received a call this morning from Dr. Jason Blaylock of Walter Reed hospital. I got to know Jason from when he came over to the office and gave me an Army medallion for giving a lecture to Walter Reed. In addition, he was involved in the care of President Trump when he got COVID. He wanted to speak to me to run by me exactly what he did in the treatment of Colin Powell to determine if I would have done anything different and if he had made any mistakes in the treatment. It was a very humble reaching out to me by a very sincere physician who cared deeply about whether he gave optimal care to General Powell. I went over with him each and every step in detail from the time Powell entered the hospital to the time he died this morning. At every single point in his care I had no problems or issues with the way he was treated or handled. I would not have done anything differently and I believe that General Powell received as good care as he could have gotten anywhere in the country or the world. It was merely an example of an 83 year old man with an underlying malignancy , in this case multiple myeloma, together with Parkinson's disease, chemotherapy for his multiple myeloma , as well as underlying cardiovascular disease and hypertension. He was given superb care and yet he still succumbed. He had been vaccinated with the Pfizer product back in February but because of scheduling and other problems, he never received a 3rd booster dose which he should have gotten given his immune compromised state. Bottom line is that I do not think anything could have been done differently. Doctor Blaylock indicated to me that they are already receiving a lot of negative social media by anti-vaxxers who are now saying that General Powell was vaccinated but he still died; therefore, people should not get vaccinated. Typical anti-vaccine nonsense. Had a very productive conversation with my UK colleague Chris Whitty. There has been some recent reports a mini-surge in cases in the UK. The UK is considerably under vaccinating children compared to the United States. In addition, they do not require that children wear masks in school. Chris mentioned that the surge is among children and that for the first time we are seeing transmission from the children who are infected in school to their parents and relatives within the household. This is very different from prior assumptions that children do not transmit infection to adults. Chris thinks that this was true with the alpha variant which was not particularly transmissible. However, he feels that with the delta variant and its high degree of transmissibility that this is what we are now seeing. He gave us a heads up because the UK is usually about a month ahead of us in the dynamics of the outbreak. We may not be seeing this type of a surge since we are pushing very hard to vaccinate children. In fact, next week the FDA will look at the data from Pfizer on vaccinating children from 5 to 11 years old. One other point with the UK is that they are not enthusiastic about mandating vaccination even though they are doing well with having vaccinated about 85% of their population with at least one dose.

Global - 241,000,000/4,900,000; USA – 45,000,000/728,000 PRESS: NBC “Nightly News” with Lester Holt; CNN with Chris Cuomo An example of the insanity out there making me the boogeyman for the extreme right. This is just one example of many: 'You're crazy': CNN reporter tells off doctor to his face after he says vaccines will result in 'genocide' Brad Reed October 19, 2021 Screen cap / CNN CNN's Drew Griffin on Tuesday conducted an interview with anti-vaccine Dr. Rashid Buttar in which the doctor claimed that COVID-19 vaccines would result in a "genocide" worse than anything Nazi dictator Adolf Hitler did during World War II. During the interview, Griffin confronted Buttar for his past comparisons between Hitler and Dr. Anthony Fauci, the nation's leading expert in infectious diseases. "You think Dr. Fauci is involved in some kind of plot to kill millions of people?" Griffin asked. "I just want to make sure I understand this." "Again, Drew, I'm a reasonable person," Buttar replied. "I said it could be this, but I can tell you that Dr. Fauci is not an innocent bystander. He is very well aware of what he is doing." Later in the interview, Buttar claimed that the majority of deaths from the delta variant of the novel coronavirus were caused by "vaccine injury," despite the fact that the vast majority of deaths came from the unvaccinated. "I don't want to be part of this mass genocide that I see happening," Buttar told him. "And I think that what's going on right now will be remembered as a worst time in history compared to... World War II." "I just want to be straight with you," said Griffin. "I think you're crazy."

(Thanksgiving Day) Global USA The New York Times had a Thanksgiving day write-up on A summary of where we are with COVID-19 in the context of an interview with me. The last question they asked was what I was thankful for at Thanksgiving. My response is given below: Adam: Last year we asked you what you’re thankful for, you very sweetly talked about your wife. What in the last 12 months are you thankful for — personally, professionally, or both? Fauci: Well, I’ll give you one of each. I’m professionally thankful that we successfully did something that was unprecedented in the history of vaccinology. And that is, we went from the sequence of a virus to a vaccine that was highly effective and safe. And we’ve been able to vaccinate a substantial proportion, although not as much as I would want, but a substantial proportion of the of the population. That’s professional. Personally, it’s the same thing. It’s no secret that I have been clearly targeted by rather radical elements who just keep attacking me every day, all day — Fox News, Breitbart — all those other crazies. And what I’m thankful for is what I said last year, that I have an incredible partner who is really amazing in her understanding of me and just keeps me grounded in reality when you have hand grenades being thrown at you every day. To have somebody that reminds you that what you’re doing is absolutely important for the health and the safety of the country, so don’t pay any attention to all that nonsense. That’s what I’m thankful for Major Serious Issue with new South African Variant!! - It is Thanksgiving Day and something has come up today that is very serious. I got an email from Jeff Zients who forwrsded an email from Stephane Bancel. Stephane was alerting Jeff to the fact that he had heard that there was a new variant in South Africa called B.1.1.529. See below: 25Nov2021 SGTF sequence report - N One of the problems is that the mutations that have accumulated which are now greater than 30 on the Spike protein including 10 mutations at the RBD would predict an escape from immune protection . In addition, the variant in RSA has rapidly gone from a couple of percent to double digits. Clearly, it is highly transmissible and has been demonstrated in people who have recovered from the Delta variant. This is very disconcerting since besides its transmissibility, this suggests that is eluding immune protection. I engaged in a bunch of phone calls with Larry Corey and John Mascola and multiple calls with Jeff Zients. I tried repeatedly to contact Rochelle Walenski, but she is not answering texts, emails or telephone calls. However, it turns out that there is a glitch in my connection to her text and my texts keep getting sent to an e-mail address. We will fix this. I finally go to her later in the evening. Larry Corey has arranged a zoom for 10:30 AM tomorrow with our South African colleagues including Glenda Gray, Penny Moore and Tulio de Oliveira who is the evolutionary biologist from South Africa. Of particular note, as I was scrambling around to contact people, the UK announced that they are banning flights not only from South Africa but also from Namibia , Lesotho , Botswana , Eswatini, and Zimbabwe. In addition, they are going to require PCR tests for all arrivals into the UK. Israel has also now announced it will ban its citizens from traveling to southern Africa covering the same countries as well as Mozambique. Again, with multiple phone calls with Jeff , we decided to wait until tomorrow morning when we will have contact with the South Africans to get a clear review of what is going on. When I finally connected with Rochelle later in the evening, it was clear that she really didn't have any idea what was going on. I am really surprised by this since the CDC should be all over these types of leads. In addition, when I began to probe it is clear that this issue had been circulating for a couple of days, and amazingly on the calls with the White House medical team Rochelle and the CDC never brought it up. This is really strange since I would imagine that with their global connections they would have been all over this. I have arranged to have both Rochelle and Francis Collins join the zoom call that Larry Corey set up for us to engage with the South Africans. Just heard tonight that the WHO has called a special meeting to address the issue: First meeting of Scientific Advisory Group for the Origins of Novel Pathogens (SAGO) https://www.who.int/news/item/24-11- 2021-first-meeting-of-scientificadvisory-group-for-the-origins-of-novel-pathogens-(sago) WHO Director-General's opening remarks at the First meeting of the WHO Scientific Advisory Group for the Origins of Novel Pathogens (SAGO) https://www.who.int/director-general/speeches/detail/who-direc tor-generals-opening-remarks-at-the-first-meeting-of-the-who-scientific-advisory-groupfor-the-origins-o f-novel-pathogens-(sago) WHO calls special meeting to discuss new Covid variant found in South Africa with ‘a large number of mutations’ https://www.cnbc.com/2021/11/25/who-calls-special-meeti ng-to-discussnew-covid-variant-from-south-africa-with-large-number-ofmutations.html?fbclid=IwAR 1VKOrWxAWjeHqVzJH0KLpPgPBRhEH lWZU KrN4bol3qFcrLgLYOjrO5aI Covid: New heavily mutated variant B.1.1.529 in South Africa raises concern https://www.bbc.com/news/health-59418127 New variant displaying a ‘big jump in evolution’ detected in South Africa. https://www.nytimes.com/2021/11/25/world/variant-south-africa-covid.html More later. I sent an email to Rochelle telling her that she better be prepared to move quickly with her team no later than tomorrow if in fact we decide that we are going to shut down travel from southern Africa. I tried to give her the benefit from my prior experience with shutting down from China as well as from the European states. She did not seem to be on top of things, and so I gave her a real strong briefing about the fact that she is going to have to move and move boldly.

GLOBAL USA All set for Zoom with RSA folks this AM. Story starting to break as the South African public health people had a meeting and discussed all the details of the increase in cases that apparently are spreading rapidly throughout South Africa. 25Nov2021 SGTF sequence report - N Not sure about the evasion of vaccines , but the situation is certainly heating up . Will discuss whether or not we're going to restrict travel from South Africa later today at a 12 noon call with Jeff. Email from Cyrus Shahpar on 11/26/2021: Deputy Health Minister in UK gave statement to Parliament about why they are prohibiting travel fro RSA and other African countries: Oral Statement on B.1.1.529 variant The Secretary of State for Health and Social Care has given a statement to Parliament on a new variant under investigation and action government is taking. From: Department of Health and Social Care and The Rt Hon Sajid Javid MP Published 26 November 2021 Delivered on: 26 November 2021 Email from Elodie Ghedin on her briefing by the South Africans: Ghedin, Elodie (NIH/NIAID) [E] <elodie.ghedin@nih.gov> Sent: Friday, November 26, 2021 8:57 AM To: Collins, Francis (NIH/OD) [E] <collinsf@od.nih.gov> Cc: Tabak, Lawrence (NIH/OD) [E] <lawrence.tabak@nih.gov>; Menetski, Joseph (FNIH) [T] <jmenetski@fnih.org>; Wholley, David (FNIH) [T] <dwholley@fnih.org>; Holland, Steven (NIH/NIAID) [E] <sholland@niaid.nih.gov> Subject: Re: New variant Good morningWe had an ad hoc/emergency meeting of the WHO Technical Advisory Group on Variant Emergence (TAG-VE) this morning with a presentation from South African scientists. We were asked to not report our discussion until the WHO puts out a statement later today so the report below is confidential. Here is the low-down: • S.A. had gotten to a stage of very low infection rate so that they noticed this new variant— B.1.1.529—because of its very rapid increase in cases; the rate of infection is higher than expected. (as background, seroprevalence in S.A. was at 80-85% so that the low infection rate they were seeing with Delta was likely due to the fact the virus ran out of susceptibles; vaccination rate is at 30%). • The first evidence was an increase in positive cases associated with S gene target failure (drop out) in the qPCR assay; Sequencing of those early samples in Gauteng showed new mutation patterns. While whole genome sequencing is still just ramping up (they have 77 genomes from Gauteng and will have 100 new ones by the end of the day), they do see the same S-gene dropout pattern in many other provinces; so far this pattern is 100% associated with the new lineage so they suspect it will be the case for these samples in other provinces. In summary: this is not a unique outbreak cluster in Gauteng. • Cases are starting to pop up in other countries, but numbers are still low. We suspect they will increase quickly. • Mutations: 10 in the receptor binding motif, many are similar to mutations observed in other lineages but also new ones. High number of mutations – • multiple in the RBD and NTD that are usually associated with resistance to neutralizing antibodies • Cluster of mutations (H655Y + N679K + P681H) adjacent to the furin cleavage site – usually associated with more efficient cell entry • NSP6 deletion (105-107) - convergent evolution as has been observed in Alpha, Beta, Gamma and Lambda - could be associated with evasion of innate immunity, possibly increased transmissibility • Mutations in the N gene - R203K and G204R (also seen in other lineages) that are associated with increased transmissibility So mutation profile is predicted to be associated with significant immune evasion and enhanced transmissibility, but no experimental evidence yet and epi data is still sparse. It clearly has a different mutation profile than other circulating VOC/VOI but full significance is not yet clear. • One big question is how this highly mutated virus emerged. There are signs of possible recombination at around nt 20,000. One of the spike mutations (N679K) is rare and also observed in C.1.2; a lot of convergent mutations observed. One hypothesis is that because of S.A.’s high rate of HIV/low CD4, this virus could have developed in immune suppression with a recombination event. • No evidence yet for different clinical presentation; age distribution tracks young so far but that's because the first outbreak was at a university, but it is also the age group that is most mobile and not vaccinated. • Most are symptomatic but severity is still being established. We are planning another meeting Monday. Will let you know if I have anything new to report. Best, Elodie Briefing with RSA colleagues: Glenda Gray, Tulio de Oliveira and others -Clearly we have a serious situation in South Africa. The virus is spreading rapidly in virtually all the provinces with a concentration in Gauteng province which is where Johannesburg and Pretoria are located. Reports now in multiple countries almost all related to travel from RSA. infections in RSA seen in people who have recovered from delta as well as breakthrough infections in those who have been vaccinated with the Pfizer product. What is unclear is what the severity of the infections are , and this is a moving target that Glenda Gray and Tulio said they would keep us informed on as soon as they get real data. Multiple countries in Europe and elsewhere are blocking travel from RSA and neighboring countries. I briefed Jeff about this immediately after the 10:30 AM zoom with the South Africans. Jeff wants me to brief the POTUS immanently. The president is spending the Thanksgiving holiday with his family in Nantucket. Conference call with President Biden: Jeff arranged for me to brief the president on a conference call that included Jake Sullivan (NSC), Natalie Quillian, Ron Klain and Jeff. I described the medical and public health situation to the President and Natalie and Ron discussed the issue of blocking travel from RSA and neighboring countries. I explained to the President that this is all the more reason to get people vaccinated and boosted. The president will make a public announcement soon, likely this afternoon, that he has spoken with me and that the decision has been made about the travel restriction. Announcement about travel restrictions went out at 2:00 PM today. 212F is the authorization for restrictions Slides on mutations: Incredibly busy Thanksgiving Day. We had zoom calls with the Pfizer group led by Mikael Dolsten to scope out what their plan is regarding scaling up boosters against prototype as well as the advisability or not of developing Omicron-specific boosters. Also met with the Moderna people for similar discussions. Clearly, the virus is spreading widely with five cases in Israel all of which were picked up by screening at the airport. E-mail from Danny Douek: Dear Tony, I have been on the phone with the Israelis this morning. They have identified 3-5 cases of B.1.1.529 One case was AZ x2. Symptomatic. Another was Pfizer x3. Asymptomatic. All identified on screening on entry at the airport. 1 case from Malawi, 1 from Jordan, 1 from Egypt via Belgium. PRESS: CNN “New Day” with Brianna Keilar (she was rude and asked questions about Brett Giroir out of context); Interviews with Sheryl Stolberg – NY Times; Kaitlan Collins – CNN; NBC “Evening News” with Lester Holt Bloomberg: U.S. Needs Data on Variant Before Limiting Any Flights, Fauci Says By Kathleen Hunter November 26, 2021, 8:17 AM EST

GLOBAL USA Conversation with Jerome (Jay) Powell, Chair of the US Federal Reserve. Bob Grady texted me this morning to connect me with Jay Powell who wanted to talk to me about the implications of the new variant on the economy since he was in the process with the Federal Reserve of making trillions of dollars in loans to other countries. He wanted to hear from me first-hand about what my projections for the outbreak would be. He will be testifying before Congress this coming week and we agreed that I would keep him posted as to any additional information that comes out. I briefed him thoroughly and what we know up to this point. PRESS: NBC “Today” with Kristen Welker and Peter Alexander;

Global USA Very Important Day!! - An extraordinary amount has been going on over the last 24 to 48 hours. It is very clear that with the Omicorn variant is rapidly spreading from the epicenter in South Africa with mostly travel-related cases to a number of countries at this point including Botswana, the Netherlands, England, Hong Kong, Australia, Italy, Israel, Belgium, Czech Republic, and several other countries. This is unquestionably a highly transmissible virus. We had a very productive zoom call at 12 noon Washington DC time with our South African colleagues once again. The main players among the South Africans were Tulio de Oliveira, Glenda Gray, and Carolyn Williamson. The have been extraordinarily transparent and helpfu giving us data in real time. It is a shame that we had to block travel from RSA. However, we would have gotten killed by the press if we did not as we are now getting killed for having done it. I expressed my deep gratitude to them for their help. The South Africans gave us a really good feel about the fact that there are things that we know and things that we don't know at this point. The combination of the many mutations in the spike protein together with the fact that they are seeing spikes in infection among people who have recovered from delta as well as those who have been vaccinated. The critical question is how severe is this disease that likely will result from this new infection. Immediately after the briefing with the South Africans, Jeff wanted me to come to the White House to help prepare the speech that the President will be making tomorrow about Omicorn. I spent a considerable amount of time in Jeff's office together with Natalie working on the presentation that I would be giving to the President this evening as well as the content of his upcoming speech tomorrow. After we worked on the presentation and his speech, we went to the Oval Office at around 3:30 PM and sat around the Resolute Desk. Briefing the President were Ron Klain, Jon Fine, Natalie, and Jeff. I gave a full briefing to the President about what the situation was with the new variant. In addition, we all sat around and edited with him the speech that he will deliver tomorrow at a White House press conference. At the end of the briefing, Ron and Jeff strongly suggested and the President agreed that I should be at the press conference with him tomorrow morning at 11:00 AM to answer any of the scientifically related questions. The President was very much in favor of this. I was a little bit concerned because I did not want it to appear that we were pushing out the surgeon general (Vivek) and the CDC director (Rochelle). BTW, both of them were not in DC (Miami and Atlanta). However, Jeff and Ron were very adamant that it be me alone since they did not want there to be any confusion about who would answer which question. One of the things that I noticed that was very clear is that the President appeared extremely tired and very muted and low key. I'm beginning to see that this is his style . However, when we got to the question and answer. He asked all the right questions. And so I can understand why his critics can often refer to him as “Sleepy Joe” when in fact he really is paying attention and is very measured in his responses. In addition, he speaks in a very low monotone which makes it appear almost that he is frail when he is not. After the briefing I rushed home and joined the Sunday night call with the COVID medical team led by Jeff. Tomorrow will be a big day. We are hearing a lot of pushback from people who are saying we should not have blocked travel from southern African countries. They fail to understand that we are not trying to completely prevent the influx of infection. Rather, we want to buy ourselves a little bit time usually measured in a couple of weeks to better prepared, understand better what is going on, and to get people vaccinated and boosted. However, as usual no matter what you do people are going to try and punch holes in it and give a reason why they think it is a mistake. I have gotten extremely used to this and understand that very well. See Below: Readout of President Biden’s Meeting with COVID-19 Response Team on the Omicron Variant November 28, 2021 • Statements and Releases Following up on the regular briefings he had on COVID while traveling, the President met in person today with his Chief Medical Advisor, Dr. Anthony Fauci, and members of his White House COVID Response Team. Dr. Fauci and members of the COVID Response Team updated the President on the latest developments related to the Omicron variant. Dr. Fauci informed the President that while it will take approximately two more weeks to have more definitive information on the transmissibility, severity, and other characteristics of the variant, he continues to believe that existing vaccines are likely to provide a degree of protection against severe cases of COVID. Dr. Fauci also reiterated that boosters for fully vaccinated individuals provide the strongest available protection from COVID. The COVID Response Team’s immediate recommendation to all vaccinated adults is to get a booster shot as soon as possible; all adults are eligible for a booster if they were vaccinated six months ago or more with Pfizer or Moderna, or two months ago or more with Johnson & Johnson. Importantly, those adults and children who are not yet fully vaccinated should get vaccinated immediately. The President will provide an update about the new variant and the U.S. response on Monday. PRESS: ABC “This Week” with George Stephanopoulos; NBC “Meet the Press” with Chuck Todd; CBS “Face the Nation” with Margaret Brennan – she played an extensive taped interview with me that is worth viewing since I pushed back on some of the nonsense that is going on. I called out Rand Paul, Ted Cruz and the far right Republicans that have been slamming me.

GLOBAL USA POTUS Press Briefing - I was called to the White House to help to prepare the President for the press briefing that he would give this morning at 11:45 AM. I got to the White House at 10:00 AM and went over his speech with Jeff and Natalie and went over the Qs and As that the President would need to prepare him. We then went to the Oval Office and directly briefed the President . In the Oval Office were Natalie, Jeff, Jake Sullivan, the vice president, Ron Klain, Jen Psaki, and a few others. We tweaked the Qa and As and helped him answer them in his own mind and then the President, the vice president, and I went out to the press briefing which took place in the Roosevelt Room. They only needed me to answer one of the questions that was asked of the President and that related to the travel restrictions on southern Africa and what we were doing right now to prevent people from other countries who might be infected with Omicron from coming into our own country. I explained that now anyone coming into the country who is not an American citizen needs to be vaccinated as well as having a test before they get on the plane whereas American citizens and LPRs need to be tested before they get on the plane and when they get off the plane they are quarantined voluntarily for seven days and must get a PCR test within three days. PRESS: ABC “Good Morning America” with George Stephanopoulos; CBS “Mornings” with Gayle King and Tony Dokoupil; PBS NewsHour with Judy Woodruff; CNN “The Lead” with Jake Tapper; MSNBC “The Reid Out” with Joy Reid; Peacock TV with Mehdi Hassan

Global USA There's been a lot of concern and discussion about the decision to block travel from southern Africa. The Africans are feeling like they're being punished as a result of their transparency in getting this information out quickly. I totally understand their concern and I do hope that this travel ban will be quite temporary. On the other hand in typical fashion the far right is now criticizing me together with President Biden for using the Omicron variant as a political tool against the Republicans. I have no idea how they make this connection, but they are totally crazy. In addition, I got criticized by the New York Post for being too slow in considering a travel restriction and therefore likely caused loss of life. Obviously, this is a lose lose situation. Had a very important conversation with Trevor Bedford last night. Trevor is a computational biologist in Seattle. He discussed some models for John Mascola, Larry Corey, and others by zoom at 8:00 PM last night. He is concerned about the immune evasion capabilities of this virus but admits that it is too early to tell what the ultimate impact will be. He believes that in a delta-immune population such as in the United States that it is very likely that this new variant will spread widely and be dominant by the time we get to the end of February. However, he underscores that this is purely an estimate on his part based on his model and may not turn out to be the case. We still do not know with the level of severity of his viruses and only time will tell. By assaying on whole virus and pseudovirus, we will have a determination in the next two to three weeks regarding the degree of immune evasion. PRESS; MSNBC with Craig Melvin; NPR with Rob Stein; Part 6 – Continued from Part 5 2022 Endings and legacy

Global USA Conspiracy theories about me continue and abound: The Harvard connection The Spectator: Was a Fauci-endorsed Chinese donation part of the lab-leak cover up? PRESS: Korean Broadcasting System documentary “Corona Chronicles interviewed by Yoonki Kang June 1, 2022 Global 527,603,107/6,290,452; USA – 83,949,036/1.002.067 It is becoming very clear that there is a different dynamic now that Ashish Jha has taken over from Jeff as the COVID coordinator. He clearly likes very much and wants to be the primary person dealing with the press. And for the first time we're seeing him wanting to do the White House press briefing alone without anyone else when it was always with Rochelle and I and sometimes Vivek. Also, it is clear that when calls are coming in for Sunday shows that the White House is putting him on instead. Since he is the boss of the coms people related to COVID, it is clear that he is telling them to do that. I do not begrudge him that because I know that he does want to be on TV a lot (and he is good at it) as he was before he took the job. But this is certainly a change in the dynamics. I'm still doing a lot of TV during the week but when it comes to things like the White House press conference and Sunday shows it is very clear that he is promoting himself above me and the rest of the team. Emily Bass wrote a terrific “Guest Essay” in the NY Times today both praising and criticizing the Biden administration or not taking a strategic approach globally towards COVID the way George W. Bush and I took towards aids with PEPFAR. It is a really good article to read for historic purposes: Guest Essay America Led on Global Health Before. It Must Do So for Covid. June 1, 2022, 5:00 a.m. ET A day or two ago Ashish, David Kessler, Rochelle, Vivek and I had an important meeting with Andrea Palm and Dawn O'Connell regarding the fact that we are running out of money and have no money left to purchase anymore monoclonal antibodies. If we do not purchase any the company will stop making it and an important tool in our toolkit will now be missing this could be disastrous for people who are immunocompromised and who do not have the capability of making anybody in response to vaccines. We pushed really hard but Andrea and Dawn had no solution for us since the Congress is still not granting us the supplement that we've been asking for for some time. We pushed hard and there was a bit of tension in the room, but we found out today have we made an impression on them since they have found some extra money to keep the antibody production going for at least a few weeks. The company, Lilly, does not want to commercialize the antibody (Bebtolivumab) and will only make it if the government pays for it. It looks like we had an impact on them when we stood together and insisted that we needed the money. Today, we had another important conversation among the team.I have been pushing and I was very explicit about it that we should make vaccine available to anyone younger than 50 years old who wants it. The emergency use authorization does not allow this right now but we are trying to find a way around this by setting up a meeting with Rob Califf to see if there is any mechanism that would allow us to make vaccine available. The reason we want to do that is that we have plenty of vaccine that we're not using and even though a fourth dose does not substantially increase the protection against severe disease (it does it a little bit), it could prevent symptomatic infection which could in the long run diminish the amount of long COVID that we experience. I came on very strong with my opinion that we should make vaccine available to anyone who wants a fourth dose at any age. Rachel was uncomfortable with this because she did not think we could get it through the FDA or the ACIP. I still insisted that we should go ahead and try. Had a very important meeting on Monkeypox today organized By Raj Panjabi (NSC pandemic preparedness leader). The meeting was attended by Rochelle Walensky, Harold Phillips of the White House AIDS office and a whole bunch of activists including Peter Staley, David Barr, and a wide range of others. Emily from my group was present as was several CDC folks. We all agreed that we need to put all our resources together and engage the LGBTQ community in our planning about testing, treating and vaccinating people with monkeypox. It was a wonderful meeting because it showed right from the beginning of what could be an important outbreak that the White House was working with the health authorities like myself and Rochelle as well as with the activist community. We vowed to continue to work together to try and make sure that this disease gets properly addressed and we do not underplay it or overplay it. There obviously is a danger of stigma generating from this disease because of its propensity to be infecting gay men. More to come on this new partnership. The New York Post is truly fabricating This has to do with the proposed “Pandemic treaty”: Beware Fauci’s scheme to empower the World Health Organization By Betsy McCaughey May 31, 202 PRESS: FOX with Neil Cavuto; “Life Itself” with Sanjay Gupta and interviewed by Seth MacFarlane (Virtually – I received a standing ovation from the audience at the Coronado Hotel in San Diego). June 2, 2022 Global USA Monkeypox continues to spread now involving over 23 countries with 800 cases. There are 19 documented cases in the USA but this is likely a very significant undercount at this point. PRESS: South Florida PBS interview for Town Hall with Michael Zinner; USA Today interview on HEROS study (food allergy and COVID) June 3-6, 2022 –Global – 528,816,317/6,294,949; USA – 84,424,159//1,003,308 I had an idyllic weekend at Jeff Zients’s palatial estate in Annapolis. Chris and I (together with Brett and Tony….) had a spectacular weekend. The weather was absolutely perfect at 85 degrees with a cool breeze and not a single cloud in the sky for the entire 2 1/2 days that we were there. We did everything: swim, boat, fish, basketball, tennis and most importantly – birdwatching. There were osprey all over the place with a nest in a tree in his back yard. There were copious varieties of birds that we saw and heard. Gave me the opportunity to return, however briefly, to some form of “normality”. it was entirely refreshing. I received an important call during my stay in Annapolis. Secretary Becerra wanted to speak to me to get my advice about whether we were doing all we can as a department to address the emerging monkeypox challenge. He was calling upon my experience in previous outbreaks to make sure that HHS (particularly CDC) was doing everything that they could. This was triggered by the fact that Ron Klain is very concerned about whether the CDC is up to the job and would not drop the ball again with regard to things like making a number of tests available. The secretary asked me what I thought the potential vulnerabilities were and I emphasized the fact that we cannot accept the CDC saying that they are the only ones that can do a test for monkeypox. We've got to convert this to a commercialization as quickly as we possibly can so that we don't have the same problem with not enough tests to understand whether or not we are dealing only with the tip of an iceberg. I offered up the cohorts of stored server that we (NIAID) have from the days of HIV/AIDS to see if there was smoldering below the radar screen infection with monkey pox among the gay population for some time before we even recognized it. Right now, as the results are coming in, it is clear that overwhelmingly the cases in the non-endemic areas of the United States, Europe, and other continents are predominantly among gay men. It is striking that the secretary “hinted” that Ron Klain is on the verge doing something dramatic with the CDC, such as removing Rochelle, which I believe would be a mistake since it is not her fault; it is the institutional rigidity of the CDC that has been the problem for decades. I explained this to the secretary and told him that it was not Rochelle that was the issue it was the structure beneath it. I got the impression that he completely understood this and was asking for my help and making sure things get done correctly. June 6, 2022 – Angela Rasmussen did an excellent job of blasting Jeffrey Sachs (and also co-author Richard Ebright) for their article claiming that COVID was due to a lab leak. See link and some selected excerpts from Angie’s tweets: Link - https://bit.ly/390lafa Not overlooked, but ignored because I don’t wish to further amplify it. But here’s a quick summary: Like many of his fellow economists with Ivy League credentials but no specific expertise in biology, he suffers from the delusion that he knows what the fuck he’s talking about. Jeff Sachs is the chair of @TheLancet COVID-19 Commission. This isn’t an official government board with any real mandate. It’s just a prestigious medical journal deciding to make up a task force of prestigious people to write more prestigious content for said prestigious journal. The Lancet COVID-19 Commission will issue a bunch of reports that are glorified opinion pieces stating the obvious: we weren’t prepared for the pandemic, there are massive inequities, it had huge global impact, need more vaccines/infrastructure, etc. This includes Richard Ebright, the human manifestation of Pepe the Frog, who spends his days squatting on his Twitter lily pad croaking at everyone who disagrees w/ his uninformed views on biosafety, virology, & evolution that they are shills, stooges, & thralls of the CCP. Feel free to lecture me about professionalism here & get blocked w/ a quickness. I gave a talk on Twitter disinfo & had an entire slide cataloguing every time he called someone (inc me) a stooge in the prior 2 weeks. He’s an abusive bigot & I don’t owe him professional courtesy. Cases starting to come down in Northeast, but still cases going up in undervaccimated areas, mostly in the South Monkeypox problem growing: Global.health tracker -- 921 confirmed MPX cases, 70 suspected (non endemic countries) https://bit.ly/392v2F1 June 7, 2022 Global - 5630,266,292/6,299,364; USA – 84,762,952/1,004,260 Note for the memoir regarding my PTSD around memories of my HIV/AIDS experience: I did an interview today (see below) with The Independent”, a UK News outlet on the issue of what I described in the NAT GEO book “Expect the Unexpected” talking about my PTSD around HIV/AIDS. The reporter asked me to describe how the PTSD expressed itself in me and what triggered it. In my description of it to the reporter, it became clear to me that it is something that I should include and expand a bit in my memoir. Last night, Stephen Hoge of Moderna explained their booster data using hybrid boosts to a group of us from HHS. The bottom line is that boosting with an omicron together with wildtype bivalent, The response protected against omicron – B.1, but not against BA.4 and BA.5. This has important implications in what decision the FDA and CDC make about what the 4th dose boost should consist of. Should it be an omicron boost or should we steer it towards BA4 and BA5 which does not seem to be protected against by maybe one boost. Met withVidar Helgesen CEO of the Nobel Foundation; Anna Sjostrom Douagi of the Foundation and Dr. Franklin Carrero-Martinez of NAS. They want me to be a lead speaker at the Nobel/NAS Symposium in May, 2023 on “trust and information”, a theme right in tune with my commencement addresses on “the normalization of untruths” PRESS: Interview with “The Independent” (UK) by Io Dodds; Interview with Theodora Tsoli for “The Bima” – Greek Newspaper; June 8, 2022 Global USA Io Dodds piece came out. Excellent historical piece: Exclusive: Anthony Fauci on the AIDS crisis, monkeypox, trans rights and his retirement In an exclusive interview with Io Dodds, Dr Anthony Fauci looks back on his decades-long career in public health Met with a delegation from the UAE on the 6th Floor of Building 31. Leading the delegation was Sheikh Abdulla Al Hamed, Chairman of the Abu Dhabi Department of Health. They are here to try and generate collaborative efforts between their group and our VRC and other elements of our program, particularly Danny Douek and Adrian McDermott In the context of the PREMISE program that was started at the VRC. This would be the first time that we are having any substantial interaction with the UAE. Cases not going down very much over past week although certain regions are plateauing: PRESS: Bloomberg TV Quick Take – “Emma Barnett Meets”; Interview with Robert Gaynes for his book second edition of “Germ Theory” June 9, 2022 Global USA The big discussion items over the past 24 hours have been the growing number of cases of monkeypox which at last count is over 1400 globally and over 70 in the United States. In addition, there was concern about what kind of decision will be made regarding the 4th shot boost with the mRNA vaccines. Although the Moderna data indicate that the bivalent vaccine of wildtype plus omicron gives quite good response to omicron, their data show only a modest protective effect with a three to fourfold decrease in efficacy against BA4 and BA.5. The data from Pfizer are even more dramatic in showing the lack of a good response against BA4 and BA5 when you vaccinate with a bivalent consisting of wildtype and omicron. The real issue is going to be that by the time the Fall comes it is very likely that neither omicron (BA.1) nor BA.4/BA.5 will be dominant since even though BA4 and BA5 are starting to take over dominance, they will likely peak and come down by the time the Fall comes and so we will be making a booster for a virus that very likely does not exist in society at the time that you are using the vaccine. Clearly, this is a major dilemma that we are all facing with the virus that moves so quickly. Good history of the evolving of variants: PRESS: NBC Medical Unit Interview with Akshay Syal; June 10, 2022 Last night I received another humbling honor associated with the honorary doctorate in science that I received from Rockefeller University in New York City. I could not attend in person because of scheduling conflict and so I taped my acceptance speech. However, last night there was a black tie affair in which individuals presented the life work of the degree recipients. Jeffrey Ravetz did an amazing job in presenting my story going back to my early days in Brooklyn. At the end of his presentation Rockefeller President Rick Lifton was very generous in his praise for me and pointed out that the audience at the celebratory dinner was giving me a standing ovation, which I could not see since I was connected to the affair by Zoom. It has been an extraordinary spring with all of these wonderful honors that I have received. This will have been my 58th honorary doctorate. Major issue that I am involved with regarding the choice of the 4th dose boost in the Fall. Everyone is trying to decide what 4th dose boosts will be given to the entire population in the Fall. A recent study by Moderna showed that there was a modest advantage of the bivalent omicron plus ancestral strain vaccine boost over ancestral strain alone when one measures antibodies against omicron. They are pushing this now to be the candidate for the 4th dose boost in the Fall. However, there is no Omicron (BA.1) around right now and even though BA.4 and BA.5 are emerging, by the time we get to the Fall we will have already peaked and declined with BA.4/5 and so we will have a vaccine that is directed against a variant that very likely will not be present in the fall and winter. We have hundreds of millions of doses of ancestral strain vaccine and in order to get a new bivalent boost available we would have to make a decision in July or August to get it ready for October or November or later, which actually might be too late. If we do not use those hundreds of millions of doses of ancestral strain they will go to waste and have to be thrown away. And so as far as I'm concerned the ancestral strain boost may not raise the titers against different variants to a very high level, but it does keep them within a protective range so I would make an argument then rather than waste millions of doses and invest in a candidate that might not do anymore of protection against a given variant in the fall and winter, we should go ahead and utilize the ancestral strain vaccines that we have which might do just as good a job against any future variants. I will try to make that case as we talk about future plans for boosters. PRESS: Zoom wih Clara Lussich of El Pais (Uruguay); Radio interview with Marc Siegel Sirius Doctor Radio; June 11, 2022 – Global USA Had a glorious and historic day at Holy Cross today. The college named their integrated science complex – “Anthony S. Fauci Integrated Science Complex” in my honor. The outpouring of love, affection, and admiration on the part of the students and the faculty at Holy Cross was very moving. I gave a Q and A session with about 30 students, which was really terrific.it is a beautiful renovated building of laboratories and classrooms. My visit to the college was on the occasion of my 60th reunion. I ran into some old friends that I have not seen in decades including Jim Mulvihill, Jack Fellin and Mike Leding. President Rougeau gave a wonderful introduction of me, and one of the thrills of the day was to see that Bob Cousy drove himself to the campus just to be there and honor me. I had a great conversation with “Cous” who is 93 years old. All in all, it was a wonderful day. I did a terrific fireside chat with David Rubenstein at the meeting of the Trilateral Commission at the Mandarin Oriental hotel in Washington DC. David was his usual humorous self and we had a typical interview that we have had several times in the past. He asked the usual questions about his own health am I kidded him about the fact that he is a hypochondriac. Prominent people at the meeting were David Petraeus, Meghan O’Sullivan, Jake Sullivan, Fareed Zakaria, among many others. PRESS: I gave an extended and exhausting all day interview with a half day photo shoot to Anna Peele, who is a freelance reporter doing a front page extensive Washington Post magazine article on me to be published in the next few weeks. June 13 – Global USA Net cases and hospitalizations coming down, but very slowly. Some counties/states coming way down while others rising or plateauing. BA4/5 becoming more dominant. Sec. Becerra got infected for the 2nd time in 4 weeks. Monkeypox getting considerably more attention. >1400 cases in non-endemic areas with ~50 cases in USA Wonderful memorial for Rob Stein at the Evermay Estate in Georgetown. I gave one of the Eulogies. Remarkable man in life and as he was dying. He was beloved by many and a very dear friend to me and my entire family June 14 – Global – 533,816,957/6,309,633; USA – 85,520,045/1,006,8890 BA4/5 creeping up in dominance: I had another very productive discussion, which I have had on a regular basis, with the UK chief medical officer Chris Whitty. We discussed the evolving situation in the UK and compared it to that in the United States. He mentioned to me that they were starting to see a surge of cases of BA5 which he feels will ultimately become dominant. In addition, unfortunately hospitalizations are starting to tick up and he believes that they are likely going to see a bit more of a wave in the coming weeks. This is very disconcerting since we were hoping that there would be a sharp downturn in omicron sublineage viruses in the UK which usually foreshadows what is going to happen in the United states. Egregious example of “PORK” on the part of the Senate Appropriations Subcommittee concerning the earmarking of funding for the BSLs not support the best science. Despite these concerns, the Subcommittee staff indicated that this directed funding would be likely to continue in FY2023and for the foreseeable future June 15, 2022 Big tragedy is that I will be missing my daughter Megan's wedding in New Orleans. This is much more painful and disturbing then the fact that I have a disease that could possibly kill me. Getting literally hundreds of texts and e-mails from all over the world wishing me a speedy recovery. Very much appreciated. Write-ups in all major news media (Times, Post, NPR, etc.). My symptoms fortunately are relatively mild with one bad night tonight with flushing feeling and a lot of primary and some cough. I started Paxlovd Jimmy Fallon: “I read that Dr. Fauci has tested positive for COVID, but luckily, he’s only experiencing mild symptoms. COVID must feel like it just reached the final boss in a video game, like, ‘We did it. We beat Fauci.’ Right now, even Fauci is reading the CDC guidelines like, ‘Damn, these are confusing.’” June 16, 2022 Global – 535,248,141/6,313,229; USA - 85,825,048/1,007,964 Feeling considerably better today. I bit the bullet and testified before the Senate HELP committee. Rand Paul was his usual stupid self asking questions about royalty payments. It was a three hour hearing and I was exhausted but I made it through. Cases, deaths, and hospitalizations seem to have stabilized and are not coming down any further: PRESS: Politico: Covid doesn't stop Anthony Fauci from taking on Rand Paul – again The two engaged in their usual heated debate at a Senate HELP Committee hearing on Thursday. June 17, 2022 Global USA Symptoms still relatively mild. I'm on day three of Paxlovid. many texts and emails wishing me well from friends and people that I do not know in the USA and around the world. PRESS: The Independent: Dr Fauci accuses Rand Paul of ‘absurd exaggeration’ over claims about booster shots Josh Marcus Trevor Noah: “Dr. Fauci has COVID, which feels a little like finding out Smokey the Bear got trapped in a forest fire.” Seth Meyers: “Dr. Anthony Fauci tested positive yesterday for a breakthrough case of the coronavirus. Fauci is like COVID’s final boss. This is like hearing that the Coyote caught the Roadrunner. Also, you caught it now? You made it through all that time in the maskless Trump White House and you caught it now? That’s like running a triathlon with no problems and then throwing your back out while petting a dog.” June 18, 2022 FDA gives EUA to Moderna and Pfizer for vaccines for children 6 months to 5 years old. CDC recommends! I'm really starting to feel the depression and sadness that I will be missing Megan's wedding today in NOLA where I would have been with my entire family had I not contracted COVID. I viewed the ceremony buy live stream as well as interacting with people during the reception and the picture taking via FaceTime .Will Fekeci and Sam provided the face timing for me. The usual stuff is going on regarding my infection with Tucker Carlson doing A5 or 10 minute discussion tearing me down but the usual accusations and belittling the people who are supporting me. What a total asshole!! I just finished Yasmeen Abutaleb’s and Damian Paletta’s book “Nightmare Scenario”. They did a very good job and I should use that book heavily as a reference in my own upcoming book. PRESS: Gov. DeSantis not recommending vaccines for children 6 months to 5 years: washingtonpost.com Gov. Ron DeSantis abandons Florida children Editorial Board But Mr. DeSantis appears to relish playing politics with public health. He is running for reelection and has his eye on a Republican presidential campaign. His decisions and comments are a craven bid for support from the anti-vaccine movement. We’ve seen this before. Mr. DeSantis also fought vaccine and mask mandates. His campaign sells “Freedom over Fauci” flip-flops that leave a message when worn on the beach: “Fauci can pound sand.” June 19, 2022 PRESS: Book about the disgraceful behavior of authorities at NY Hospital-Presbyterian (particularly Laura Forese) during the outbreak peak in NYC: Facing Death During the Pandemic Marie Brenner’s “The Desperate Hours” looks at how health care workers dealt with the perils of Covid. By Sandeep Jauhar June 20 2022 Tested negative today and have had an essentially asymptomatic course. Began reading Deb Birx’s book “Silent Invasion” and it is clear already from the first couple of chapters that she is revising history regarding her initial involvement. I am sure that part of it is true but it wants me to be careful that I have to be strict to the truth of exactly what happened and not pad it in my favor Important discussions today by phone with me and separately David Kessler, Larry Horowitz, Richard Koup and Peter Marks regarding what the ultimate choice for the booster vaccine for the upcoming fall surge. I have been very concerned of late that we are not carefully analyzing the immunological basis for the choice of a booster shot to be administered before the potentially upcoming Fall surge. The companies Pfizer and Moderna apparently want to give a bivalent of wildtype plus omicron since that is what they already seem committed to and are making. It is my opinion that by the time we get to the fall season omicron will be completely gone and off the map since it is already gone. The closest thing that we likely would see would be a surge of BA4/5. Yet everything seems to be pointing to the decision of doing an omicron/wildtype bivalent. Peter Marks who will make the ultimate decision at the FDA agrees with me that we will be fighting yesterday's war if we go with omicron. There will be many discussions this week that I will catalyze to make sure that we get all the appropriate information for the FDA to make a good decision about the booster. June 21, 2022 GOP threatening me if they assume control over Congress: Top Republican On House Oversight Eyes Hunter Biden, Fauci As Investigative Targets – ‘The Takeout’. CBS News (6/17, 5.39M) reported that “if Republicans take control of the House in the next Congress, the House Oversight Committee” would investigate NIAID Director Dr. Anthony Fauci, according to Rep. James Comer (R-KY), the top Republican on the committee. Fauci has “maintained that COVID-19 likely resulted from a ‘natural occurrence,’ as opposed to a lab leak in Wuhan, China, telling a Senate committee this week that the virus likely jumped from ‘an animal host, perhaps through an intermediary host, into a human species, which then spread throughout the human population.’” Comer told CBS News chief Washington correspondent Major Garrett on this week’s “The Takeout” podcast, “We are not going to let up on that. I think the American people deserve to know the truth about COVID 19. They deserve to have a government try to actually find the truth about where the COVID 19 originated from.” Clyburn’s Committee has finally shone a bright light on the destructive nature of the Scott Atlas dogma of “herd immunity” and the Great Barrington Declaration: House Select Subcommittee on the Coronavirus Crisis New Select Subcommittee Report Reveals Full Scope of Trump Administration’s Embrace of a Dangerous and Discredited Herd Immunity via Mass Infection Strategy

Press Release Report is the first in a series on the Select Subcommittee’s investigation into the Trump Administration’s political interference with the federal coronavirus response PRESS: Read this. More preposterous nonsense about me by the radical right media. This is one of hundreds of such items coming out on a daily basis: The Fauci Protocol: Treating Fauci’s Covid Diagnosis According To His Own ‘Standard Of Care’. For “The Corner” of the National Review (6/17, 798K), George Leef linked to a piece in the Brownstone Institute by Jordan Schachtel, who argued that NIAID Director Dr. Anthony Fauci, is unlikely to follow his own advice after being infected with COVID-19. Regional Press – Nextstar with Raquel Martin; Hearst with Christopher Sales; Gray with Molly Martinez; “Fatherly” with Tyler Santora; Telemundo National with Francesco Fajardo; Parents Magazine with Nicole Harris; June 22, 2022 There has been some considerable tension between the new H-CORE group who is headed by Jason Roos and the rest of the HHS tream. They are involved in making major decision about distribution of money. Yet the leadership component of H-CORE consisting of the following has not been consulted on any major decisions: Several people including Cliff Lane and I are concerned that decision are being made in a vacuum and Jason seems uninterested in calling the leadership group for advice and consultation PRESS: regional press: The Klay Kane Show (Sirius XM) with Klay Kane; Revolt TV with Ryan Dennis; The Midday Party on Hot 103 Jamz (Kansas City) with Julee Jonez; Cox with Kirstin Garris; WSB (ABC Atlanta, GA) with Linda Stouffer; WDIV (NBC Detroit, MI) with Dr. Frank McGeorge June 23, 2022 Real problem evolving with people having got infected at Megan’s wedding on June 18. Megan is devastated since at least a dozen family members and friends seemed to have gotten infected while in NOLA, likely, but not definitely at the wedding. Rep Steve Scalise is agitating with Rep Jim Jordon about getting me to testify or be questioned in closed doors by the House Select Committee on the Coronavirus Crisis chaired by Rep. Jim Clyburn. They are saying that the USG is “hiding” me. Clyburn does not want to allow it since he knows they will make it into a circus. However, they are playing it out publicly that I am hiding something and that is why I do not want to testify. If it were up to me, I would absolutely testify. PRESS: BBC News TV; White House Press Briefing (of note, this is the 1st one that I have briefed at in several weeks (see my comment above about Dr. Jha) June 24, 2022 We are stuck at around 100,000 cases/day and this is very likely a significant underestimate. Deaths remain low: Had and important Zoom conversation with Peter Marks and a whole bunch of people (see below) regarding the upcoming choice of a booster for the fall season. I am in favor of a bivalent wild-type/BA4/5 or a monovalent BA4/5. June 25, 2022 Bad day with rebounds sxs. Started on 2nd course of Paxlovid June 26, 2022 Feel much better this morning, on my second day of Paxlovid. Will take it very easy today and see what happens over the next couple of days. I'm reading Deb Birx’s book and it can serve as a really good reference for me to refresh my memory about dates and events. June 27, 2022 Just for the record – Ashish Jha is promoting himself on all major TV and clearly excluding Rochelle, Vivek and me. Rather obvious and a big deviation from Jeff Zients approach We seem to be “stuck” at around 100,000 cases per day (surely an underestimated since most cases are not reported due to home Ag tests) and 300 deaths per day: June 28, 2022 Monkeypox cases continue to increase. USA activists (James Krellenstein et al) now increasing pressure on HHS (ASPR) to be explicit on how many tests, antivirals, vaccines are available for distribution. PRESS: National Press Foundation Roundtable; Foreign Policy Global Health Forum Keynote; June 29, 2022 Patterns starting to show insidious increases in all parameters: PRESS: Monkeypox press briefing (with Raj Panjabi) for LGBTQ community press; Multi-cultural media briefing for children vaccines Daily Mail: Anthony Fauci says that he's experienced rebound Covid symptoms after taking a Pfizer's antiviral Paxlovid - which studies now show is NOT effective for people who are vaccinated. Washington Post (Online) The Pandemic Is Waning. Anthony Fauci Has a Few More Lessons to Share. America’s most famous doctor on mitigating covid, giving your adversaries the benefit of the doubt and working way too much By Anna Peele June 29, 2022 at 10:17 a.m. EDT June 30, 2022 Still recovering from COVID. I had a rebound as indicated above after stopping my first course of Paxlovid. Have now finished my second course and my antigen positivity is very very slight. Hopefully it will disappear by tomorrow. Little by little going in the right direction. Important zoom meeting with Karl Lauterbach (Minister of health of Germany), Ugur Sahin (CEO, BioNTech) and Ashish Jha. We discussed the pros and cons of what the optimal booster would be in the fall. Carl and Ashish called upon Ugur and me to give the scientific rationale of why our FDA has come down on the side of recommending a BA.4/5 bivalent (with Wild type) boosts for the fall. Although it may take a little bit longer to get enough doses to start off early in the fall, the advantage of having a powerful BA.4/5 stimulus and response may be worth the slight delay. We also agreed that if we get a surge very early in the fall before we have enough BA/4/5, then we can actually boost with the ancestral monovalent since this does induce a reasonable response although not optimal against BA. 4/5. Karl mentioned that Germany had been leaning towards and omicron bivalence, particularly in the context that this is what Moderna has been pushing since that is what they have decided to make at risk and they don't want to lose the use of those dosages. At the end of the discussion it was clear that Ugur and I convinced Karl that the better direction to take would be as discussed above with BA. 4/5. It was a very good discussion and I came away impressed that Ugur is a brilliant scientist and seems to be a really nice person. Had my usual every two week zoom call with Chris Whitty of the UK. Chris and I have developed a very good relationship and we exchanged information about what is going on in the UK compared to what is going on here. They are unclear as to what boosts that they would use given the fact that they do not believe that they will have enough time to get enough BA. 4/5 boost made to meet a potential false surge we both agreed that if the surge comes early they can utilize the unused ancestral Wuhan vaccine that they have plenty of. PRESS: The New York Times (Shery Stolberg): Fauci says he believes Paxlovid kept him out of the hospital, even though he tested positive again. Dr. Anthony Fauci, President Biden’s top pandemic adviser, sought to discourage doubts about the antiviral drug Paxlovid following what appeared to be a “rebound” of Covid-19 after taking the pills. July 1, 2022 Global – 543,352,927/6,331,059; USA – 87,298,343/1.012,767 Tested Ag negative today!! Importance of vaccination + boosters: Cases clearly going up everywhere in the USA and in UK: I am struggling with the issue of what the precise and most appropriate time to step down from my current position to move on to writing books and entering the next phase of the winter of my career. It is very difficult for me to pull away from being the director of NIAID given the extraordinary history that I have created and lived through over the last 38 years as director. As we approach the decision making time of this summer although I lean very strongly two announcing my departure in August and leaving at the end of 2022, the thought of this still causes considerable anxiety in me as to whether or not I am doing this too soon. However, I will be 82 years old at the end of the year and I have always said that I want to go out while I am still very much on top. That is the driving force that has me feel that I will go through with the plan PRESS: https://paw.princeton.edu/article/commencement-speakers-offer-parting-words-2022-grads July 2, 2022 2nd day in a row Ag negative Noteworthy is that Senator John Kennedy (R-LA) despite his seeming antagonism of me sent me a very nice, handwritten “get well soon” note. Monkeypox problem growing….. Global.health: 6178 confirmed MPX cases in 67 non-endemic countries; 51 suspected. 459 in USA July 3, 2022 UK reporting anther “concerning variant – BA. 2.175 July 4, 2022 I had a very relaxed day today. Went on a nice walk. After that we hung around the house and towards the evening we went fishing on the canal but, as usual, we didn't catch anything. Yesterday was a fun day in that not only did we go for a good walk, but I also threw the baseball around in preparation for my trip to Seattle, and then Brett and I shut around some baskets at Horace Mann school. Next week is going to be a tough week in that there's a lot of stuff going on in addition I have my CT scan on Sunday. July 5, 2022 Global USA Recent article in The Atlantic by Cary Gross and Zeke Emanuel criticized the NIH for not moving quickly or effectively enough on research on COVID. Larry Tabak wrote a letter in strong response: THE CONVERSATION Letter: The NIH Has Responded Forcefully to COVID-19 The nation’s leading health-research agency, its acting director writes, has moved with unprecedented speed against a global threat. July 6, 2022 Global USA Activists including James Krellenstein, Gregg Gonsalves and Peter Staley among others are getting agitated at HHS and NSC (Raj Panjabi) for the lack of Jynneos (MVA – Bavarian Nordic) for PrEP for Monkeypox for the Gay community (MSM) MPX cases increasing greatly in USA especially in DC, NYC and Chicago July 7, 2022 BA.2.75 increasing in Australia, India and several other countries. Some cases in USA. Watching it closely Met with Adam Russell, Acting Deputy Director of newly formed ARPA-H PEPFAR Oral history: https://www.bushcenter.org/publications/essays/pepfar.html PRESS: Newsy TV Interview; Radio New Zealand RNZ; July 8, 2022 Global USA PRESS: Mother Jones Interview on HIV Vaccines with Jackie Lynn Mogensen July 9, 2022 People are acting like and hoping that COVID is over, but it is not. There are still >100,000 cases/day which is likely a gross undercount since many cases (perhaps x5) are not reported and deaths are stuck at ~300 with hospitalizations increasing: I had a conversation with Rochelle and Vivek about this today (Saturday) indicating that I believe we are not doing enough in a proactive way of getting out there with the press and in other venues talking up how we need to increase mitigations such as reminding people about the importance of wearing masks as well as pushing to get people vaccinated and boosted. Also, as I have said in the recent discussion with Dan Diamond of the post in which he tweeted I would discussion that we need to be more liberal in getting people a fourth shot who are less than 50 years old but might have some underlying conditions without necessarily being immune compromised. Bottom line is that I am pushing that we be more aggressive. I am disappointed that I have not been out in the classic media of TV and radio either because the media are not interested or because the White House is not sending them my way. The same holds true for Rochelle and Vivek. They are not being out there as much as I believe we all should be. Officials have been debating, for months, Dan Diamond tweet: whether to recommend a 2nd booster, especially because so many Americans haven’t gotten their 1st. But TONY FAUCI told The Post he’s “leaning toward flexibility” for more younger Americans to get another booster shot. MPX still increasing in USA and around the world. In USA 790 reported cases. Likely and undercount. Global.health 9060 confirmed MPX cases in 71 non-endemic countries, 40 suspected Politico – Story about BARDA contract to company Phlow to make continuous generics. They did not fulfill their contractual responsibility. Trump-era federal Covid contract recipient has yet to meet major deadlines Two years in, Phlow Corp. has not delivered on high-tech methods to domestically manufacture cheap generic drugs. Peter Navarro was likely influential in picking the company that was not even a company yet when BARDA gave them hundreds of millions of dollars: “Evidence uncovered by the Select Subcommittee raises questions about whether White House officials, including Mr. Navarro, exercised inappropriate influence over contract awards for [personal protective equipment] and medical supplies that should have been handled by career procurement staff,” the letter continued. July 10, 2022 Asymptomatic monkeypox virus Preprint (MedRXiV): infections among male sexual health clinic attendees in Belgium We need to be careful that we do not fall into the same issue that we did early on with COVID, i.e. not appreciating the importance of asymptomatic spread. Follow-up Chest CT – Unchanged!!! July 11, 2022 On our weekly call with the secretary, I brought up the issue that we need to be much more proactive in warning people about the spread of infection and that we have to be pushing the wearing of masks and getting people vaccinated and boosted. The secretary agreed and we're going to discuss this even more with Ashish tomorrow. Washington Post article describes my pushing to be more aggressive during this surge of BA.5 variant: Biden officials push to offer second booster shots to all adults Plan would make coronavirus shots available to millions more amid rising cases, hospitalizations. By Dan Diamond, Laurie McGinley and Lena H. Sun While the booster plan still needs formal sign-off from regulators and public health officials, it has the backing of White House coronavirus coordinator Ashish Jha and Anthony S. Fauci, the government’s top infectious-disease expert, according to five officials who spoke on the condition of anonymity because they were not authorized to discuss the plan. In an interview, Fauci said that he’s “leaning” toward allowing second booster shots for younger adults, pending authorization from the Food and Drug Administration and agreement by the Centers for Disease Control and Prevention. While persuading those who haven’t gotten vaccinated or fully vaccinated to get the full regimen and their first booster shot is critical, Fauci said, “we also need to allow people who are under 50 to get their second booster shot, since it may have been months since many of them got their first booster.” “If I got my third shot [in 2021], it is very likely the immunity is waning,” Fauci added. July 12, 2022 Was called to the White House for a meeting with Ron Klain, Ashish Jha, Sec. Becerra, Richelle Walensky and Dawn O’Connell. Ron was really ****** that he is getting a lot of Flack from New York City who feels that they are not getting enough doses of monkey pox vaccine. Ron is upset with the formula of distribution among the states. He feels that doses are being sent to places with few cases and not being used and there are lines of people waiting to get vaccinated in New York City and they are making a big stink about this causing what may turn out to be a political problem for POTUS. I kept quiet through most of the discussion which was pretty tense between secretary Becarra and Ron. However, it became clear to me that the lesion was that the contractor who is shipping the doses from Denmark to the United States do not appear to realize that this is an emergency and they're talking about sending one plane per week with about 140,000 doses per plane. I brought up the point when Ron mentioned that I was being very quiet and he wanted to know my opinion. I said that it is inconceivable to me that we cannot do better than 140,000 doses shipped per week when we have about a million doses in Denmark sitting ready to be shipped. I believe that this is an example of people not pressuring to get things done during an emergency and accepting business as usual. The astounding fact is that they said that the reason they have to rely on the plane flying back from the United States to Denmark to reload with another bunch of vaccines is that they only have limited carriers to put the vials in when they are shipped on the plane. What are they talking about?? One can make carriers with 3D printers. In addition, I don't understand why they can only do 140,000 at a time. After the meeting I emailed Dawn and expressed to her my astonishment that we can't do better than this. She checked and found out that all of a sudden they could now ship 400,000 doses of vaccine per plane instead of 140,000. In addition I encouraged her to work with the Department of Defence to get more planes in the air. This is another example of a serious logistic snafu that could have easily been solved if somebody was just thinking with a clear head. ------------------------------------------------------------ Good coverage of the White House press conference where I emphasize the need to take the current situation seriously without letting it disrupt our lives: Fauci: Take new subvariant seriously, but The Hill - don’t ‘let it disrupt our lives’ by Peter Sullivan - 07/12/22 11:10 AM ET As BA.5 spreads, the White House warns NY Times – Sheryl Stolberg that Covid is not over. : “Variants will continue to emerge if the virus circulates globally and in this country,” Dr. Anthony S. Fauci, Mr. Biden’s chief medical adviser for the pandemic, said at a White House news briefing. “We should not let it disrupt our lives. But we cannot deny that it is a reality that we need to deal with.” PRESS: White House Press Briefing; MSNBC with Chris Lansing; Nexstar with Don Kauffman; Interview with Eileen O’Reilly for Axios; Fox TV with Neil Cavuto; July 13, 2022 Hospitalizations going up. Deaths stable at ~300/day. BA4/5 >80% of isolates with BA5 >50% Europe having a big surge of BA5. Met with Bob Barnett again last night planning the announcement of my stepping down and the subsequent linking up with publishers and speaking bureaus after I actually leave. GOP in Congress inappropriately trying to shut down all research collaborations with China: Draft bill would ban CDC, NIH from funding lab research in China House of Representatives measure catalyzed in part by suspicion that pandemic virus escaped from Wuhan laboratory • 12 Jul 2022 • 6:00 PM • ByJocelyn Kaiser PRESS: CNN “New Day” with John Berman July 14, 2022 Global – 5546,897,312/6,356,812; USA – 88,932,987/1,018,035 Cases, hospitalizations, and deaths now going up: Rochelle called me up tonight and arranged to have a zoom with me to get my advice about pressure she is getting from the White House who is responding to New York pressuring them to get more monkey pox vaccines (see above on July 12). This relates to the meeting we had a couple of days ago with Ron Klain where he was very concerned that we are being perceived as being unresponsive with regard to vaccines and the POTUS is getting a lot of pressure from NYC for more vaccines. The White House wants her to distribute the vaccine according to the number of cases and she feels correctly that that is not a totally fair way since there is a consideration for the at-risk population in certain locations that don't yet have a lot of cases. Also, southern states with black MSM are not really tresting since they are stigmatized and cases are not being recognized. I counseled her that it is a battle she will lose if she insists on distribution other than just by case numbers. She will lose the fight with the WH. In 1 to 1 and 1/2 weeks there will be hundreds of thousands of vaccines shipped from Denmark. At that point we can do what I would strongly suggest is to blanket the at risk community with vaccines for everyone who is at risk particularly those who are on prep for HIV or who are infected with HIV and are suppressed with their viral load due to antiviral drugs. Those are the ones that are out there having sex and not feeling vulnerable because they are on antiviral therapy. I told her to hang tight for week or so and the problem will solve itself. PRESS: Rickey Smiley Radio Show; KAMR TV Amarillo, TX; NBC Livestream News with Phil Lepof; CNN with Erin Burnett; July 15, 2022 Global USA After talking with Ashish this morning, Rochelle decided to allocate vaccines for monkeypox at 75% according to the number of cases and 25% for the level of risk and a given community. That seems like a reasonable compromise which I agree with and will back Rochelle on. As mentioned above, in two weeks this will be a moot point since there will be hundreds of thousands of doses of vaccines arriving from the outside. We are not keeping up very well on booster shots: PRESS: Univision Digital with Borja Voces; Skimm TV ONLINE with Maria Corpus; Bloomberg TV “Balance of Power” with Joe Mathieu

PRESS: CNN with Laura Coates July 17, 2022 (Sunday) Important conversation with Ashish Jha. But she's called me up and wanted my opinion and backing on what he wants to bring up to Ron Klain. He wants to propose putting billions of dollars into a program that would mimic operation warp speed in which he has been calling “hyperdrive”. The purpose is to put a full court press on getting you closely administered vaccines to prevent infection and transmission as well as next generation platform and imagine designs for greater breadth and durability of response. These latter concepts word described by me to him. The reason Ashish wanted my help was that he heard from Ron that unless we're proposing something that is more than just incremental and that would actually be transformative and play a major role in turning around how Americans think about COVID, then he doubts that Ron will take the step to go to the president to have the president use a chit with the Congress to get the money. The trick about all of this is that Ron will want a product to go into the arms of Americans within 18 months to coincide with approaching the end of the administration and the election for the presidency. I told Ron that I would back him on the transformative nature of the two pillars that I mentioned above, but I have considerable skepticism as to whether or not we can do this in 18 months. I suggested to Ashish that week altogether a group comprised of him, me, Peter Marks and Rob Califf from the FDA as well as some knowledgeable people from biotech and pharma. Unless we have corporate sponsors we are not going to go anywhere with this and we will never be able to do it in 18 months. Ashish will set-up the meeting and hopefully we can make a determination and get back to the president. Ashish feels that if we cannot convince Ron about this then there is no way that we can get the money. July 18, 2022 Sarah Ohermohle wrote an article in Politico where I mentioned that I would be leaving the NIH sometime before the end of President Biden's first term to which is January 2025. This is being interpreted by many in the press that I'm announcing my retirement. This is obviously not the case because I have given no date for stepping down and I am not retiring when I leave government service. However given the interest in me it is not surprising that this is now gone viral: Anthony Fauci wants to put Covid’s politicization behind him The disease fighter says he’s plotting his departure and reflecting on how he wants to be remembered. Financial Times: Kiran Stacey US chief medical adviser Anthony Fauci to step down in Joe Biden’s first term Kiran Stacey 4-5 minutes Washington Post: Fauci says he will retire from government post by the end of Biden’s term By Yasmeen Abutaleb July 18, 2022 at 11:45 a.m. EDT New York Times (Sheryl Stolberg): Fauci Says He Will ‘Almost Certainly’ Retire by January 2025 Dr. Anthony S. Fauci, 81, said he expected to see out President Biden’s current term. Wall Street Journal – Stephanie Armour and Betsy McKay Anthony Fauci Plans to Retire by End of Biden’s Term One of the leading public faces of the U.S. public-health response to Covid-19 says he hasn’t decided on exact date ---------------------------------- I had a very good talk today with Sam Bankman-Fried and his brother Gabriel Bankman who runs a foundation called “Guarding Against Pandemics”. Also on the call were their associates Jacob Swett and Annabel Snidow. (see above) . We spoke about how Sam with his billions of dollars could partner with the NIH and pushing the scientific agenda for the prototype pathogen approach of pandemic preparedness. Sam is a good friend of senator Joe Manchin and Joe is the one who originally pointed Sam in my direction to see if somehow we can all work together to having some sort of a partnership where the Congress puts in a certain amount for pandemic preparedness using the prototype pathogen model and Sam puts in an equal amount to support the effort through NI AID. We left it that they put together a proposal and that I serve as the scientific advisor for the amount of money that Sam wants to put into this even though I must be careful and will be careful about not getting involved in writing any legislation since Manchin has been talking about writing this into a reconciliation bill. PRESS: CNN with Kate Bolduan; Reuters interview with Julie Steenhuysen; NBC Online Web; NPR with Rob Stein (talking about the Politico article (see above) July 19, 2022 I had an important conversation this morning with Peter Staley in which I asked his advice about messaging to the gay community regarding monkey pox. There seems to be a debate in New York City among public health officials versus some gay leaders. The tension is whether or not to tell gay men to hold off on multiple sexual partners until they get a PrEP version of the vaccine. Some people are saying that that would increase the stigma against gay men. However, Peter agrees with me that there is nothing wrong with and probably a good idea to tell gay men to just hold off and cool it for the next couple of weeks until we get enough vaccine to vaccinate all people who are at risk namely those who've had multiple sexual partners within the last 14 days. I will be out in the press talking about this and I just wanted to check with Peter as to whether he agreed with me and in fact he does. BA.5 dominating isolates: PRESS: The Hill Health Summit Interview and streaming with Steve Clemons; Good Housekeeping with Zee Krstic; WHUR 96.3 FM DMV/ HBCU Network with Harold Fisher;WJLB 97.9 Detroit with Bushman; WNYM (FOX-NYC) TV with Lori Stokes; July 20, 2022 I just had an important conversation with Rochelle in which I related to her the conversation that I had last night with Carlos Del Rio in which Carlos articulated that there's a great deal of concern and agitation in the gay community, which I already am aware of, regarding the difficulty in getting TPOXX for the treatment of monkey pox. I decided to call Rachel and give her a heads up that the community is really starting to get very agitated to the point that they may be attacking the administration and her and the FDA and all of us in the press if we don't do something soon to cut down the difficulty in getting TPOXX to those in need. I suggested to her that she and the FDA think in terms of doing something akin to the parallel track approach that I initiated decades ago during the HIV pandemic. She will look into this with her people. I had a great meeting today in building 31 with Dr. Karl Lauterbach, the Minister of Health of Germany. He relied heavily very heavily on my advice about how to handle the decision about and distribution of booster shots for COVID in Germany. He is having some of the same problems as we are having here in trying to decide what the correct booster should be in the fall. He has already ordered millions of doses of Moderna bivalent which is an omicron plus ancestral as well as Pfizer which is a BA.4/5 bivalent plus ancestral. Moderna is obviously pushing their product, but Karl was very interested in what my opinion was. I told him that on the advice of me and others, the FDA has already authorized the bivalent of BA.4/5 and ancestral for the full dose. It is now up to the CDC and teir ACIp to make a recommendation f who “should” versus “may” receive the dose. We also spoke about the tension regarding vaccinating people now who are at risk of severe complications given that there is a wave of infections in Germany as well as in the United States versus waiting until a more variant-specific boost is available in the fall. Germany is facing the same dilemma as we are in that some people in Germany are arguing in a very similar way to Paul Offit who is saying that we should not be vaccinating people now. Paul is smart and a good friend but he is a victim of what I consider making the perfect the enemy of the good. From a purely immunological standpoint it is obviously not optimal to have a boost now (ancestral) and require an even better boost (bivalend BA.4/5 + ancestral) just a couple of months down the pike. However, you have to balance the public health benefit of getting some form of vaccine to people who are at risk for infection and severe disease now compared to the relatively minor negative effects of giving a vaccine shot now followed in 2 to 3 months by a vaccine shot with a better boost. I was surprised that bloggers such as Paul Offit have a major impact globally. Karl mentioned to me that he and his colleagues listen very carefully to what I say and it would be very helpful to them to hear what I am telling him today and that I agree completely with him since he is absolutely in the same lane as I as well as many of my NIH colleagues including Rick Koup and others. It was a very stimulating conversation and I was on my A game. We then went on to discuss the issue of monkeypox. According to Karl monkey pox is out of control in Germany and similar to what we are seeing in the United States the gay community is very frustrated with the lack of as many vaccines as they need as well as the lack of easy access to antivirals. They seem to be having no trouble with diagnostics which are plentiful. I explain to him that our situation is very similar here in the United States. The conversation ended with him wanting to take a picture with me since his daughter who is 15 years old apparently is a great fan of mine. We exchanged cell phone numbers and he promised me that he would be calling me frequently. John Laureman (Bloomberg) wrote a very nice laudation of me today: An Early Farewell to America’s Top Pandemic Expert July 21, 222 Harassment from the far right continues: Rand Paul Sends Message To Fauci: You’ll Have To Testify Under Oath If GOP Wins. Fox News (7/20, 23.99M) reports, “Sen. Rand Paul, R-Ky., issued a warning to Dr. Anthony Fauci: If the GOP takes back Congress in the midterms, be prepared to testify under oath regarding the coronavirus pandemic.” On Wednesday, he argued on “America Reports” that “the American people deserve the truth and answers on whether there was a cover-up for a lab leak in China.” President Biden tested positive today (Thursday)! Tested negative on Tuesday, went to Boston on Wednesday; had mild sxs this AM and tested positive. https://www.whitehouse.gov/wp-content/uploads/2022/07/Letter-7.21.pdf Obvious media storm. He has mild sxs. My only concern in the way that his MD (Kevin O’Connor) is treating him is that he D/C’d his Eliquis and Lipitor. I do not care about the Lipitor, but I am very concerned about the discontinuing completely of the Eliquis. The president has a atrial fibrillation and I would have merely lowered his dose to 1/2 the dose rather than completely discontinuing it because of my concern about him throwing analysis in getting a stroke. I mentioned this to a sheesh during a briefing called this evening since we are all going on television tomorrow. Couple of interesting things related to the infection of the president. 1) I called up Kevin O'Connor who is the physician to the president and got a briefing from him for the simple reason then when I go out on TV and I'm asked whether or not I have been consulted with it would be rather embarrassing to say that they did not call the so-called most famous infectious diseases expert in the world, who happens to also be the chief medical advisor to the president. I explained to Kevin my concern about the anticoagulation. He understood my concern and said that he has started the president on low dose aspirin which is a good thing. Kevin explained that the president was negative for an antigen test on Tuesday, did not sleep well on Wednesday evening, and woke up on Thursday predominantly with fatigue. Tested himself on a routine basis which for him is 2 to three times per week. The test came back positive, confirmed by a PCR. Throughout the day he then began to get sniffles, at first a dry cough and then a loose cough. His temperature rose to 99.4 F, which came back to normal with tylenol. His oxygen saturation was 97 to 98%. He was resting reasonably comfortably when Kevin left him tonight. 2) We had a meeting with the comms people and Ashish Jha this late afternoon in preparation for media requests tomorrow. I was under the impression that they were going to spread out the request for morning shows between Ashish and me. I found out later in the evening that all the morning shows will go to Ashish and they will give me regional meeting in the afternoon. As mentioned several times above it is very clear that Ashish is trying to dominate the media scene with regard to COVID-19 and is telling his staff to lead me out of the major media hits. Again, he does a good job but it is a bit of Bush league to do that. I have asked Courtney to communicate with the White House calms people and two in a very nice way ask them just what is going on here. Monkeypox continues to spread throughout the world. 15,000 cases worldwide in 70 countries; >2000 in USA: Monkeypox Virus Infection in Humans across 16 Countries — April–June 2022 J.P. Thornhill, S. Barkati, S. Walmsley, J. Rockstroh, A. Antinori, L.B. Harrison, R. Palich, A. Nori, I. Reeves, M.S. Habibi, V. Apea, C. Boesecke, L. Vandekerckhove, M. Yakubovsky, E. Sendagorta, J.L. Blanco, E. Florence, D. Moschese, F.M. Maltez, A. Goorhuis, V. Pourcher, P. Migaud, S. Noe, C. Pintado, F. Maggi, A.-B.E. Hansen, C. Hoffmann, J.I. Lezama, C. Mussini, A.M. Cattelan, K. Makofane, D. Tan, S. Nozza, J. Nemeth, M.B. Klein, and C.M. Orkin, for the SHARE-net Clinical Group* The activist community is very angry. See Washington Post article: Opinion The Biden administration’s monkeypox response has been a mess By Gregg Gonsalves July 21, 2022 at 3:56 p.m. EDT PRESS: FOX “Good Day” NYC TV with Rosanna Scotto; WGN Chicago Radio with Peter McMurray and Rob Martier; July 22, 2022 Kevin O'Connor called me this morning at 10 48 AM to give me an update on the president's condition. He is quite stable has a slight fever up to 99F that is easily brought down by tylenol. He has a cough which started off as dry but now is a bit “loose” as described by Kevin which means it seems deeper in the chest. However, the president feels well enough to continue to work from the White House although he is a bit fatigued as you might expect. More later. Letter from Kevin O’Connor to the USA – POTUS doing well: The Guardian – Gay community in revolt about monkeypox. Article about Peter Staley: ‘Nobody’s acting like this is an emergency’: Act Up veteran Peter Staley condemns US monkeypox response Wilfred Chan Rochelle has pleaded with me to back the CDC plan of distributing vaccine more on the basis of at risk population then on the actual number of cases since it is anticipated that with a variety of gay pride galas coming up including “Southern Decadence” among others that although there are not a lot of cases in the southern states including Louisiana, there will be soon and although New York City and other large cities but particularly in New York City is hammering the White House about the lines that there are to get vaccine in people who perceive themselves and in fact are practicing risk behavior even though they have not been in direct documented contact with an infected person. The White House is responding to the complaints of the gay community that the response to the monkeypox outbreak has been a terrible disaster (see above with Peter Staley) and they are pushing Rochelle and the secretary to distribute it favoring New York since they have the most cases. Rachel wants me and I agree to back her in making it a 75% on risk and 25% on cases whereas the White House wants the distribution to be 25% on risk and 75% on cases. I believe that this is short sighted because we are quickly going to see areas that do not have a lot of cases now but will very soon not having enough vaccine to prevent the outbreak. I was very forceful in the zoom call with the secretary and the HHS team in saying that I would back Rochelle; however, we must have the flexibility of apportioning doses to the at risk locations in small allocations so that if they don't use them we will not have given them all of their doses at one time and thus cannot recall them to give them to cities and locations that actually have a large number of cases. Once you send doses to a location, by FDA regulations, you can't pull them back and send them somewhere else. And so smaller allocations are the answer. Whether or not Ron Klain will accept this is a big question. He is very interested in the political blowback from New York. This is understandable since he is a politician but he is not looking at it from a purely public health standpoint. I was very forceful with the HHS team when the comms people were suggesting that we explain this gap that we have in availability of vaccines on the lack of funding. I told the secretary on the zoom that I have to be frank with them, but I thought that this would be a total disaster since that is an excuse and not an explanation and the gay community would kill them for making excuses. I mentioned that we had to own the problem and tell them that it would have been nice to have all the doses that everybody needed, but the fact is we don't have all the doses and therefore we will do everything we can to get as many doses to people as we can in an equitable manner. Bottom line is that I told them what I told the Trump administration, and that is the only way to solve a problem is to first own the problem. Was on multiple TV shows (see below). One of the things that came up was why the president's physician, doctor Kevin O'Connor, was not out there describing the president's condition. I answered that I was not in the loop and I did not know why. However it is very clear as mentioned above and as confirmed by Dori Solcido that Ashish really wants the spotlight and wants to be the one talking about the president's condition. I consider that an unforced error because that's what the press is going to focus on that we are hiding something. I do not want to get into that seen Ashish wanting to essentially be on every single possible major TV show, but that's the way it is. Also, the White House was concerned that Kevin mentioned that the president had a temperature of 99.4F. the temp responded very well to Tylenol and I brought up too Dory as to how foolish it is to get upset because Kevin mentioned his temperature. It is the perfectly normal thing to have a low grade temperature with a upper respiratory infection. Even though this White House is a good White House they're concerned about message control is ill advised and they are only making unforced errors. I spoke again tonight (10:00 PM) with Kevin O'Connor and he brought me up to date on the President's condition. He still requires Tylenol to keep his temperature down. He is very comfortable and even played some golf on the putting range in the White House outside because he was getting a little bit cabin fever. According to Kevin he continues to improve, but Kevin is concerned about Paxlovid rebound and is considering giving him eight days of the drug. He wanted my opinion as to whether or not that was a good idea. I am ambivalent about this since there will be a lot of blowback about why he was treated differently than the recommendations. Cliff lane would not treat him for an extra few days but would take the chance that he was going to rebound. I will recheck with Kevin tomorrow. I had a long talk with Raj Panjabi (NSC) who sought my advice about how to deal with the activist group who feel that he is lying to them and that they have lost confidence in his ability to give them straight information. I mentioned to Raj that he needs to be straight with the activists and put himself in their shoes where they are looking at hundreds of millions of dollars invested in a product to be put in this row tegic national stockpile, and now that we need that product it is not available to the gay community. They are outraged and all he and his colleagues are doing is making excuses for it (see above about owning the problem). I made it clear to Raj and cannot have his comms person speak to Peter Staley, David Barr, and James Krellenstein et al. he must do it himself otherwise it would be showing disrespect to the activists. Raj was extremely grateful for my tutoring of him in this regard. PRESS: CBS Livestream Online; NY1 Spectrum News TV with Kevin Frey; Alice Park with Time magazine; ABC World New Tonight; NBC Nightly News with Lester Holt; CNN “The Situation Room” with Wolf Blitzer; FOX News with Brett Baier; MSNBC “The Beat” with Ari Melber; KMOJ FM (Minneapolis) with Freddie Bell; Univision National with Andrea Linares; Telemundo National with unknown July 23, 2022 Yesterday I spoke with dawn O'Connell and told her that I would be very much in favor of the secretary declaring a public health emergency for monkeypox. She is now running it up the chain to see what others think about that.. I had my usual call this morning with Kevin O'Connor, the president's physician. It was a disturbing call because Kevin told me that Ashish is really trying to manipulate what Kevin says regarding the health of the president and Kevin is starting to get very aggravated by this. For example, Ashish did not want Kevin to mention that the president's temperature was 99.4F because then that would be a topic for the news discussion. That is completely ridiculous because it is totally expected that someone with a URI would have a mild temperature responsive to Tylenol. In addition, Ashish did not like the use of the word “malaise” which was the exact word the president used to describe how he felt. Ashish was afraid that that word would bring up recall of president Jimmy Carter and the negative response that the country had to his describing “malaise” in the country. And then finally in today's report Kevin wanted to put in a new symptom that the president complained of which was muscle aches, an entirely understandable symptom that has nothing to do with progression of disease. They insisted that he not add that. Kevin pushed back and said that he would not sign off on anything if they force him to hold back on what the true symptoms are. Call from Larry Horowitz regarding Ron Klain saying to him (Larry) that the President wants to make some changes since Health area (COVID/MPX) is not going well. “Someone needs to get fired.” Primary target is Becerra, but they feel that they cannot fire him since they never would get a replacement confirmed in he Senate. Next in line in Rochelle. They really are disappointed with Rochelle and want to fire her. They asked Larry for suggestions for replacements. Larry called me about this. He suggests Mark McLellan or Anne Schuchat. Wants names from me. Larry also called Jeff Z. They do not know that Jeff is working with me regarding my stepping down. Could get complicated. I called Jeff and we discussed the situation. See below my discussion the next day (Sunday) with Jeff. Had a long conversation with Jeff about the above issue concerning firing someone at HHS/CDC. Similar to the situation that I faced years ago with Secretary Burwell wanting to fire Tom Frieden because of poor performance with Ebola where I defended Tom, I found myself defending Rochelle. Rochelle is a wonderful person, but she does not have control over her agency and she has to learn to balance the politically expedient thing while still maintaining solid scientific principles. The problem is she relies too heavily on the entrenched people at CDC who are smart and will meaning but who have no oversight or quality control from the outside. This allows them to proceed with somewhat antiquated if not ossified ideas. As the discussion went the options were to fire Secretary Becerra; however, this would be very difficult since it would be tough to get a Senate confirmation for a secretary within a relatively acceptable period of time. The other option is to fire Rochelle, but now is not the time to do that and it would be against my recommendation. One of the points that Jeff made is that they are considering in a humane way to ask Rochelle to step down at the end of the year before the beginning of the second-half of the first term. Despite my trying to protect Rochelle there is a very good chance that that will happen. Kevin O’Connor continues to call me 2x/day. The president continues to improve and is completed his 4th day on Paxlovid. .He was out for four hours today by the pool doing reading work. The next big question is whether to give him eight days or 10 days instead of five days of pax livid. That would be a problem since it would be against FDA authorization and the public would cry out that we had treating him differently than other people. the concern on the part of the White House is that if he rebounds after he is negative for several days, he will likely be out talking and mingling with people. If he infects someone following an inadvertent rebound, he will be blamed for infecting other people. My suggestion would be to treat him for five days have him stay in the White House virtually for an additional five days testing him everyday if he turns negative as soon as he turns negative send him out even if it's before the 10 day. And have him wear a mask in order to avoid him inadvertently infecting people if he rebounds, I would just test him every morning before he gets up and goes out to meet with people. If he is negative he will be OK, if he is positive continued isolating. Emergency phone call among HHS people (Becerra, Dawn et al) regarding convincing POTUS (and Ron) to declare a Public Health Emergency (PHE) for MPX. Becerra says that POTUS will rely heavily on my opinion. Problem is that they are concerned that if you declare a PHE for monkey pox then why not declare it for gun violence or for reproductive rights. That sounds very much like the negativistic attitude of RON. PRESS: ABC “Good Morning America” Weekend; CBS Mornings (Weekend); CNN “New Day” Weekend; Fox News with Neil Cavuto July 24, 2022 Kevin O’Connor continues to call me 2x/day. The President continues to improve and is completed his 4th day (Sunday) on Paxlovid. He was out for four hours today by the pool doing reading work. The next big question is whether to give him eight days or 10 days instead of five days of Paxlovid. That would be a problem since it would be against FDA authorization and the public would cry out that we had treating him differently than other people. The concern on the part of the White House is that if he rebounds after he is negative for several days, he will likely be out talking and mingling with people. If he infects someone following an unrecognized rebound, he will be blamed for infecting other people. My suggestion would be to treat him for five days, have him stay in the White House virtually up to an additional five days testing him everyday. If he turns negative, as soon as he turns negative send him out even if it's before the 10 day period. And have him wear a mask in order to avoid him inadvertently infecting people if he rebounds, I would be OK, if he is positive continued isolating. Had long conversation with Ashish who was asking my advice. He started off the conversation by saying that the White House continues to have a lot of problems with Rochelle, the latest of which was the apportionment of vaccine doses. (See discussion above about strong consideration of asking her to step down). Ashish said that Ron wants my take on the situation with Rochelle/CDC and the distribution of vaccine doses. She wants to divide the vaccines for monkey pox according to the formula of 25% according to cases and 75% according to risk. This is something that we had discussed yesterday in a call with the secretary. During that call I promised that I would back Rochelle's proposal because of the fact that if they do not distribute more, namely 75%, according to risk, when we have outbreaks related to “Southern Decadence” and other gay pride functions we will not have vaccine in place to counter it. However Ron Klain is adamant that he does not want vaccines shipped to locations in which there are few cases and when they do not get cases or they do not administer vaccine to their case countthat the vaccine goes to waste (you cannot reship vaccine). I made the following point to the secretary yesterday and I repeated it word for word to Ron today. I would be supportive of a 25% for cases and 75% for risk distribution only if the jurisdictions that received the 75% for risk are given the vaccines in small apportionments. For example if they were scheduled to get 400 vaccines, you would give them 100 and tell them that if they don't use that 100 expeditiously the next shipment of 100 would not be given to them but would be given to a jurisdiction that has a high number of cases. I explained this to Ron when he called me today and told him that that would be my position. He said that Ron is very interested in what I would do and that this would hold a great deal of weight in the discussions that we will have tomorrow, which is Monday. Had a long conversation with Jeff about the above issue concerning firing someone at HHS/CDC. Similar to the situation that I faced years ago with Secretary Burwell wanting to fire Tom Frieden because of poor performance with Ebola where I defended Tom, I found myself defending Rochelle. Rochelle is a wonderful person, but she does not have control over her agency and she has to learn to balance the politically expedient thing while still maintaining solid scientific principles. The problem is she relies too heavily on the entrenched people at CDC who are smart and will meaning but who have no oversight or quality control from the outside. This allows them to proceed with somewhat antiquated if not ossified ideas. As the discussion went the options were to fire Secretary Becerra; however, this would be very difficult since it would be tough to get a Senate confirmation for a secretary within a relatively acceptable period of time. The other option is to fire Rochelle, but now is not the time to do that and it would be against my recommendation. One of the points that Jeff made is that they are considering in a humane way to ask Rochelle to step down at the end of the year before the beginning of the second-half of the first term. Despite my trying to protect Rochelle there is a very good chance that that will happen. Kevin O’Connor continues to call me 2x/day. The president continues to improve and is completed his 4th day on Paxlovid. He was out for four hours today by the pool doing reading work. The next big question is whether to give him eight days or 10 days instead of five days of pax livid. That would be a problem since it would be against FDA authorization and the public would cry out that we had treating him differently than other people. the concern on the part of the White House is that if he rebounds after he is negative for several days, he will likely be out talking and mingling with people. If he infects someone following an inadvertent rebound, he will be blamed for infecting other people. My suggestion would be to treat him for five days have him stay in the White House virtually for an additional five days testing him every day if he turns negative as soon as he turns negative send him out even if it's before the 10 day. And have him wear a mask in order to avoid him inadvertently infecting people if he rebounds, I would just test him every morning before he gets up and goes out to meet with people. If he is negative he will be OK, if he is positive continued isolating. Of note, Ashish states that he wants Kevin to go up in front of the cameras to describe the President's condition, but it is Ron who does not want him to go up as well as Karine JeanPierre. That is interesting because I am hearing that it is Ron who does not want Kevin to get up in front of a camera. PRESS: MSNBC with Jonathan Capehart July 25, 2022 Spoke with Kevin O'Connor again this morning and evening. the president is doing extremely well and continues to improve. He we'll complete his fifth day of Paxlovid today. The next question will be when he can go out into society. I have a phone call with Ashish this afternoon and I will recommend that we not give him additional days of drug but that we have him stay masked inside for 5 days or until he tests negative by antigen test. They are concerned about rebound; however, I have told them that if he tests every morning for five to 10 days after his Paxlovid course ends and he does not show any positivity, he can go out that day and proceed with business. That would be much more acceptable to the general public then to give him an extra few days of drug which would not actually guarantee that he does not rebound. PRESS: The Hill “Rising”; CBC Radio with Robin Bresnahan; July 26, 2022 Continuing my twice per day discussion with Kevin O'Connor regarding the president's condition. The POTUS Is doing very well and improving substantially each day. Today is one day following the termination of his Paxlovid therapy and his CT level is 35 which means that he has very little replication competent virus in his nasopharynx. He feels very well and we had a long discussion this evening with Kevin, Ashish Jha, and Ron Klain as to what the presidents activities could be looking forward. He tested negative today by antigen test and has a very nice CT level as mentioned above. The White House staff is concerned about possible rebound and I made a suggestion that he stay masked and in isolation until he gets two negative antigen tests in a row. After that he can go out and do duties on the outside provided that he does not travel and that he wears a mask. I would test him intimately a few times a week to see if he rebounds. It became clear to me that Ron Klain and the president rely heavily upon my advice but what to do with the president's condition. I have developed a very good relationship with Kevin O'Connor and he calls me twice a day. We had some serious discussions with secretary Becerra about having a consistent message about the distribution of the monkey pox vaccine. See above about the concern of having vaccine in places that are not being utilized well there are lines in other jurisdictions. I supported the CDC recommendation of distributing the vaccine with 75% to risk areas and 25% to actual cases so long as individual jurisdictions utilize the vaccine. The CDC will send out the vaccine in tranches that will not be followed up with more vaccine until the jurisdiction actually utilizes the vaccine so that we don't have unused doses in one area and demands more than supply in another area. We also discussed whether or not we should declare monkeypox a public health emergency. I argued strongly that we do that in order to send a signal to the MSM community that we are very serious about the situation that they find themselves under. We had the vaccine summit today in the Indian treaty room of the executive office building. I gave a talk on the NIH research agenda. Also I did an enormous amount of press today which overlapped with a number of meetings with the White House as well as with secretary becerra. Big time stressed today and I feel it. PRESS: CNN “New Day” with John Berman; MSNBC “Morning Joe”; NPR “All things Considered”; News Nation Now TV; MSNBC “The Reid Out” with Jason Johnson July 27, 2022 Paper in Nature today validates my disagreement with the CDC last year when Vivek and I pushed back against their saying that you do not need to test after 5 days of isolation after infection since most of the transmissions occur in the first few days of infection and after day 10 you are OK (see prior notes): How long is COVID infectious? What scientists know so far Those with SARS-CoV-2 are often advised to isolate for only a few days. But evidence is mounting that some people can continue to pass on the virus for much longer. • David Adam POTUS back to work. The letter below is based on conversations I had last night with Ron, Kevin, Anita Dunn, Mike Donilon, etc.: I was part of the opening panel of the introduction of the UN aids report very beginning of the IAS meeting in Montreal. The name of the report presented by Winnie Byanyima (Exec Director of UNAIDS) is “In Danger”. Also on the panel was John Nkengasong (PEPFAR), Adeeba Kamarulzaman (President of IAS), Andriy Klepikov (Dir. Alliance for Public Health in Ukraine, Keren Dunaway, International Community of Women Living with HIV, Anita Vandenbald Canadian MP. AP reporting on the above: People are exhausted with epidemics and pandemics,” said Dr. Anthony Fauci, the U.S. government’s leading AIDS expert. “We have to fight twice as hard to get HIV back on the radar screen where it belongs.” Yesterday it was a little bit of a distributing and embarrassing situation where Raj Panjabi piggy-backed his own little mini session on monkey pox right after Vaccine summit at the White House at the very last minute without letting dawn or Connell know until literally I have to now will before he was asking her to speak. bottom line is it all is that although everyone agrees that Raj is a really good guy and his heart is in the right place he is really over his head in his job at the NSC in charge of pandemic preparedness. Dawn believes that the White House is well aware of that and that is the reason why they are appointing any “Monkeypox Tsar” Washington Post: The Fauci ‘ouchie’ was a near miracle. We need another. By the Editorial Board July 27, 2022 at 2:51 p.m. EDT Variety: Dr. Fauci, Roberta Flack and Zora Neale Hurston Documentaries on the Way, PBS Boss Announces Went to a terrific social function at the incredible home of Adrienne Arsht at 6 Chevy Chase Circle. It was a cabaret night where American Pops Orchestra founder/leader had a contest played old songs and had the audience guess the singer. I thought that I might win since I got only 2 wrong, but Renee Fleming won with an even better score. Had interesting conversation with Brett Baier where he finally admitted that the 2 recent Science papers by Worobey, Andersen, Rasmussen et al convince him that the lab leak theory is really not true. PRESS: New York Daily News interview with Tim Balk; NPR WBUR Boston with John Ringer; Dr. Anthony Fauci says government response to monkeypox must address anti-gay stigmas Muri Assunção, New York Daily News July 28, 2022 Cases and hospitalizations continue to rise slowly with very little increase in deaths. I recommend to Becerra to declare PHE. Monkeypox: Global.health: 20,671 confirmed MPX cases, 42 suspected in 84 non-endemic countries. 4600 in USA. 2 children infected in USA from mother who had sex with bisexual man The Montreal Gazette concerning my comments (virtually at the UNAIDS report unveiling): Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases in the United States and chief medical adviser to U.S. President Joe Biden, said the UNAIDS report is “a reminder that the global plague” of HIV/AIDS “continues to rage,” even though much of our attention diverted to the global pandemic of COVID and now, monkeypox. “All of us in the global HIV community must work to reach vulnerable communities,” he said, and the report is a reminder that “we can do better in this, the fifth decade of AIDS. The priority must be to implement better treatment modalities, while improving and optimizing the next generation of interventions.” The COVID pandemic and, now, monkeypox, mean “people are exhausted with epidemics and pandemics. We have to fight twice as hard to get HIV back on the radar screen, where it belongs,” Fauci said. I was involved in a very difficult zoom cool this evening with Peter Marks. Rob Califf, Vivek, David Kessler, Julia Tierney (FDA), Hillary Marston, among others about the potential conflict that might occur tomorrow when Ashish has convinced the president to come out and say that anyone who's not been boosted recently should get boosted. However, we now know that both moderna and Pfizer will have the BA.5 bivalent boost available the first week of September. This will create a major messaging problem since we are telling people to get boosted with the vaccine that doesn't cover the current BA.5 variant when the actual variant-specific boost will be available 5 weeks from now. Somehow or other Ashish took the initiative to convince the president to say this without consulting with the FDA or the CDC. If these mixed messages go out it will be a major cluster. I tried to bring this up to them and suggested strongly that they have a zoom in the morning before any of these announcements are made in order to get a common message otherwise it will look like one of the worst mixed messages to come out in a long time. I'm starting to see right now the advantage of having Jeff as the coordinator since he understands the interactions among the different agencies of government whereas Ashish is smart, a very good communicator and is well meaning, but he is more about looking like he's taking the lead on things than coordinating. Later in the evening, I had dinner over jeff's and Mary’s house which was a great evening. Guests at the dinner besides Chris and I were: Susan Rice, Secretary of Defense Lloyd Austin and his wife Charlene, Deb Harmon, Wally Adeyemo. The discussion was very stimulating particularly Susan Rice telling us stories of her escapades during the Obama administration and secretary Austin telling us about the tension in his multiple responsibilities. One of those discussions of the night was the desire of Nancy Pelosi to go to Taiwan which everybody feels is a very bad idea given the geopolitical situation. However for some reason she feels she needs to go there and everyone seems to be against it. July 29, 2022 See e-mail chain below regarding the confusion about mixed messages related to my note yesterday: From: Fauci, Anthony (NIH/NIAID) [E] <afauci@niaid.nih.gov> Sent: Friday, July 29, 2022 7:35 AM To: Marks, Peter (FDA/CBER) <Peter.Marks@fda.hhs.gov>; Califf, Robert <RMC001@fda.hhs.gov>; Tierney, Julia (FDA/OC) <Julia.Tierney@fda.hhs.gov>; Tabak, Lawrence (NIH/OD) [E] <Lawrence.Tabak@nih.gov>; O'Connell, Dawn (OS/ASPR/IO) <Dawn.Oconnell@hhs.gov>; Levine, Rachel (HHS/OASH) <Rachel.Levine@hhs.gov>; Murthy, Vivek (HHS/OASH) <Vivek.Murthy@hhs.gov>; Kessler, David (HHS/IOS) <David.Kessler@hhs.gov>; Varrone, Michael (HHS/OGC) <Michael.Varrone@hhs.gov>; Roos, Jason (OS/ASPR/H-CORE) <Jason.Roos@hhs.gov>; Mahon, Barbara (CDC/DDID/NCIRD/OD) <bdm3@cdc.gov>; Goldstein, Robert (CDC/OD) <qyd2@cdc.gov>; Berger, Sherri (CDC/OD/OCS) <sob8@cdc.gov>; Marston, Hilary (FDA/OC) <Hilary.Marston@fda.hhs.gov> Subject: RE: Confidential – Next Steps on Expanding Eligibility for Additional Booster Team: I know that we are all struggling with this and trying to get it right, but I really have a problem with the 4/8/12 message. It is not that it is incorrect from a medical and/or immunological standpoint. It is that it will it be very confusing. I know that we are trying to save lives by getting people vaccinated and boosted; however, for the overwhelming most part, the people who are going to get vaccinated (particularly the elderly) are already vaccinated and I am not sure how much we are going to move the needle in getting the “unboosted” to get boosted when we are simultaneously saying that in 5 weeks we will have a much better and more specific vaccine. That is an inherently confusing message that would be counterproductive. Right now if we were three months away or even two months away from a variant specific boost I could see making a big push to get people boosted now. However, starting with Monday we will be five weeks away from a variant specific boost. If we want to have one cogent prevailing message it is that we have a very important boost that will be available in five weeks. The message should be focused on that. Anything that confuses that will work against us. Just my take…. Thanks, Tony Anthony S. Fauci, MD Director National Institute of Allergy and Infectious Diseases Building 31, Room 7A-03 31 Center Drive, MSC 2520 National Institutes of Health Bethesda, MD 20892-2520 Phone: (301) 496-2263 FAX: (301) 496-4409 E-mail: afauci@niaid.nih.gov The information in this e-mail and any of its attachments is confidential and may contain sensitive information. It should not be used by anyone who is not the original intended recipient. If you have received this e-mail in error please inform the sender and delete it from your mailbox or any other storage devices. The National Institute of Allergy and Infectious Diseases (NIAID) shall not accept liability for any statements made that are the sender's own and not expressly made on behalf of the NIAID by one of its representatives. From: Marks, Peter <Peter.Marks@fda.hhs.gov> Sent: Friday, July 29, 2022 6:58 AM To: Califf, Robert <RMC001@fda.hhs.gov>; Tierney, Julia (FDA/OC) <Julia.Tierney@fda.hhs.gov>; Tabak, Lawrence (NIH/OD) [E] <lawrence.tabak@nih.gov>; O'Connell, Dawn (OS/ASPR/IO) <Dawn.Oconnell@hhs.gov>; Fauci, Anthony (NIH/NIAID) [E] <afauci@niaid.nih.gov>; Levine, Rachel (HHS/OASH) <Rachel.Levine@hhs.gov>; Murthy, Vivek (HHS/OASH) <Vivek.Murthy@hhs.gov>; Kessler, David (HHS/IOS) <David.Kessler@hhs.gov>; Varrone, Michael (HHS/OGC) <Michael.Varrone@hhs.gov>; Roos, Jason (OS/ASPR/H-CORE) <Jason.Roos@hhs.gov>; Mahon, Barbara (CDC/DDID/NCIRD/OD) <bdm3@cdc.gov>; Goldstein, Robert (CDC/OD) <qyd2@cdc.gov>; Berger, Sherri (CDC/OD/OCS) <sob8@cdc.gov>; Marston, Hilary (FDA/OC) <Hilary.Marston@fda.hhs.gov> Subject: RE: Confidential – Next Steps on Expanding Eligibility for Additional Booster Dear Rob, Thanks. Perhaps the 4/8/12 messaging is going to be the best way to go then At least 4 weeks if you are over fifty until next booster (I know the immunologist don’t love this, but there are different antigens in the booster and mRNA vaccines are not the same as protein based vaccines. This seems to balance the potential benefits and risks) At least 8 weeks if your are under fifty At least 12 weeks if you recently had COVID If you are immunocompromised, you will need to wait at least 4 weeks, but follow your healthcare providers recommendation Best Regards, Peter From: Califf, Robert <RMC001@fda.hhs.gov> Sent: Friday, July 29, 2022 6:26 AM To: Tierney, Julia <Julia.Tierney@fda.hhs.gov>; Tabak, Lawrence A (NIH) <lawrence.tabak@nih.gov>; O'Connell, Dawn (OS) <Dawn.Oconnell@hhs.gov>; Fauci, Anthony S (NIH) <afauci@niaid.nih.gov>; Levine, Rachel (OS) <Rachel.Levine@hhs.gov>; Murthy, Vivek (OS) <Vivek.Murthy@hhs.gov>; Kessler, David A (OS) <David.Kessler@hhs.gov>; Varrone, Michael (OS) <Michael.Varrone@hhs.gov>; Roos, Jason (OS) <Jason.Roos@hhs.gov>; Mahon, Barbara (CDC) <bdm3@cdc.gov>; Goldstein, Robert H (CDC) <qyd2@cdc.gov>; Berger, Sherri (CDC) <sob8@cdc.gov>; Marks, Peter <Peter.Marks@fda.hhs.gov>; Marston, Hilary <Hilary.Marston@fda.hhs.gov> Subject: Re: Confidential – Next Steps on Expanding Eligibility for Additional Booster Had a good “Ashish session” late last night. He is moving forward, but understands that the faster than expected timetable for bivalent vaccine is a really good thing. He agreed that its critical that we reach agreement on the best set of words that capture the common ground that we want people to get boosted (now 5 RWE studies showing the big effect of even the 4th shot on reducing death and hospitalization), but with the bivalent imminent lower risk people have the good option of waiting. For those who get boosted now—they can still get the bivalent in xx weeks. From my view the only thing that will be bad for public health out of our options would be for us to have different messages. All other options are a net positive in terms of reducing death and severe illness. rmc From: Julie Tierney <Julia.Tierney@fda.hhs.gov> Date: Thursday, July 28, 2022 at 10:41 PM To: Robert Califf <RMC001@fda.hhs.gov>, Lawrence Tabak <lawrence.tabak@nih.gov>, "O'Connell, Dawn (OS)" <Dawn.Oconnell@hhs.gov>, Tony Fauci <afauci@niaid.nih.gov>, Rachel Levine <Rachel.Levine@hhs.gov>, Vivek Murthy <Vivek.Murthy@hhs.gov>, David Kessler <David.Kessler@hhs.gov>, "Varrone, Michael (OS)" <Michael.Varrone@hhs.gov>, "Roos, Jason (OS)" <Jason.Roos@hhs.gov>, "Mahon, Barbara (CDC)" <bdm3@cdc.gov>, "Goldstein, Robert H (CDC)" <qyd2@cdc.gov>, "Berger, Sherri (CDC)" <sob8@cdc.gov>, Peter Marks <Peter.Marks@fda.hhs.gov>, "Marston, Hilary" <Hilary.Marston@fda.hhs.gov> Subject: Confidential – Next Steps on Expanding Eligibility for Additional Booster As a follow up, we’re still working through the FDA statement and will circle back tomorrow morning with next steps. Thanks for your patience. Had a very interesting conversation with the HHS team regarding a memo at the secretary will be sending to the president regarding the declaration of a public health emergency (PHE). the secretary expressed some concern about whether we should do that or not but his staff actually wrote a memo making it seem like he definitely wanted it I brought this out to them when I read quickly the memo while we were on the Zoom and the secretary requested that I can't fully look at the memo and make comments. I actually think we should definitely declare a PHE and I modify it the conclusion of the memo to be unambiguous about this. It was really strange that the secretary said he had reservations and his staff wrote a memo that strongly recommended that we do it. In my memo back to them I told them that they have to make up their mind one way or the other and have the memo strongly recommend what he actually wants. I rewrote the conclusion assuming that he will take my recommendation to declare it July 30, 2022 (Saturday) Just got a call at 12 noon from Kevin O'Connor that the president has had a rebound with a positive antigen test today. He is asymptomatic. This is the real problem since there are no guidelines from the CDC which dictate what to do when you have someone who you are testing virtually every day. The CDC health advisory on what to do following a rebound after Paxlovid treatment does not mention testing at all. the duration of isolation is based purely on symptoms and time from resolution of symptoms. Here again it goes back to my objection many months ago of the guidelines the CDC put out about reentry into society following infection. I had insisted back then that even though it might not be practical for everyone to get testing and often people need to get back to work after five days, they still should have put some guidance in for people who can get tested period now we are flying in the dark. Ron Klain is going to want him out as soon as possible; however, given that he is known to now be antigen positive he has to isolate for five days and then the question will arise of how often to test him and if he is positive should he be let out even with a mask. Cliff Lane feels strongly that he should be in isolation so long as he is antigen positive and can go out once he has two negative tests in a row. Got a call from Ashish making sure that we are on the same page. Also, he asked me if we should start a 2nd course of Paxlovid. I told me not to unless the POTUS gets significant sxs Rep. Lauren Boebert (R-CO) spoke about a proposed rule that would lower Dr. Fauci's salary to $1.Stay ConnectedForbes on Facebook: ... Flag as irrelevant *****Wall Street Journal piece by Peter Loftus on July 29, 2022 is critical in its historical portrayal of the interaction of NIAID and Moderna/Pfizer. Important for the book!! WSJ: The Partnership That Made the First U.S. Covid Vaccine Gay community getting very agitated about that they perceive as the government’s slow response and resting the rapidly evolving multi pox outbreak: Frustration builds in LGBTQ community over government response to monkeypox Jen Christensen, CNN 12-15 minutes July 31, 2022 I gave the special session plenary lecture at the International AIDS Society (IAS) meeting in Montreal via a virtual presentation. I have given a plenary lecture and virtually every one of the IAS meetings since 1984. I reflected on what has transpired since the last meeting in Montreal which was in 1989. My presentation triggered a prolonged standing ovation from the audience. The session was chaired and moderated by Laura Waters of the UK. The president remains antigen positive for the second day in a row following his rebound. His CT values are 16 to 18. He has had no additional symptoms although he still has somewhat of a lingering cough. The plan is to keep him isolated until he asked two negative antigen tests in a row. I got a call from Rochelle who is stuck in Amsterdam following the cancellation of her flight from Amsterdam to Washington. She is coming back from a trip to Uganda and Kenya. She thanked me profusely for sticking up for the CDC's decision about allocation of vaccines for monkey pox. Got a call from Jen Ashton of ABC expressing concern about something that I have been almost obsessing about today and most recently. That is the fact that the public may be taking monkeypox too lightly assuming that it will stay confined to the population of men who have sex with men. In addition, we are doing nothing proactively to encourage people to cancel such events as ”Southern Decadence” and Black gay pride galas. We are starting to see cases of spillover into non men who have sex with men populations. Also, there is so much that we do not know about the Natural History of this disease and with the potential is to spread beyond MSM. I will have to talk to people at HHS and the White House that we cannot under play this outbreak. Call from Francis Collins, Acting Science Advisor to POTUS regarding NIH Director Choice – Charles Sawyer at MSKCC. Francis wants me to talk to him about the possibility of his being considered for the job of NIH director. It is essentially a recruiting call that Francis wants me to have with Charles. Apparently the president is not satisfied with either of the two names that was submitted to him: Mary Klotman (Duke) and Kimryn Rathmell (Vanderbilt). August 1, 2022 I have been somewhat concerned about Monkeypox the very beginning, but I am getting more and more concerned about it as time goes by. It clearly is spreading rapidly throughout the world the community of MSM with an estimated doubling time of about seven days; my concern is that we are all seeing some spray into the non-MSM communities such as the recent is very much bothering me is the continued plans to have MSM and gay pride galas at the same time that we are having acceleration of COVID as well as outbreaks of monkeypox (see above my conversation with Jen Ashton) I got my usual follow up call from Kevin O'Connor regarding the President's condition. He is concerned that his viral load is going in the wrong direction, namely, his CT value went from 18/16 to 16/14. He called me together with Walter Reed ID physician Wes Campbell to see if I agreed with them that they should not restart Paxlovid since the president does not have any new symptoms and his oxygen saturation is 98%. His chest is clear despite the fact that he has his typical nagging cough that antedated his illness. I agreed with them that they should not start a second course of Paxlovid. The administration will announce tomorrow that they are appointing a monkey pox Coordinator (Bob Fenton) and a Deputy Coordinator (Demetre Daskalakis). Clearly the response or at least the perception of the response of the government to monkeypox has not been good. They are hoping to reinvigorate the response by this appointment. Tonight, Kevin Munoz (WH Comms) called me and he asked me if it was OK to put a quote in the press release supporting this decision. The White House feels that because of my street credibility with the gay community that this would make the choice more acceptable. I agreed and provided a brief quote. Overwhelming evidence of benefit of vaccines and boosts: July 2, 2022 *****Important debate going on that relates back to the conflict that I had with the CDC I was concerned that they did not call for antigen testing following infection before someone is able to go back out into society. The president got infected, went on Paxlovid, and then rebounded. And so the question is when can he go back into society. Since he is the president and we test them every day he is staying isolated until his antigen test reverts to negative. At the same time, a number of papers including in the NEJM have shown that the median time of reversion to negative antigen test is actually five days and many people stay positive until day 8,9,10 and beyond. The CDC recommendations say that after five days since no requirement is made for testing (which I was very much against this decision and caused a ruckus by disagreeing with the CDC many months ago), A person can go out into society after five days with the mask so long as they have no symptoms. And after 10 days, if they still have no symptoms they can take their mask off. This obviously Will lead to people going out into society who are still antigen positive and are likely spreading the virus. That was my original concern when I disagreed with the CDC. BA.5 now 86% of isolates in USA: A lot of activity working with Rob at the FDA and Ashish and CDC to get the right messaging about recommendations for the booster in the fall. The FDA would like to say that the bivalent BA.5 boost is significantly better then the mono valent ancestral strain boost. There is a lot of pushback from the immunology community led by John Moore saying that the bivalent BA.5 boost is only marginally better then the monovalent ancestral strain. The data is somewhat confusing as explained below in an e-mail from Rick Koup to me. The debate is whether to ask people who are otherwise that low to moderate risk to get vaccinated now with the ancestral strain will wait until September when a supposedly much better boost is available. Most of us have no problem with low risk people waiting, however, I and others are concerned about overselling that the bivalent boost is much better then the ancestral boost, which is not the case I will list a couple of emails below that outline the dilemma: From: Fauci, Anthony (NIH/NIAID) [E] <afauci@niaid.nih.gov> Sent: Monday, August 1, 2022 6:53 PM To: Califf, Robert <RMC001@fda.hhs.gov> Cc: Murthy, Vivek (HHS/OASH) <Vivek.Murthy@hhs.gov>; Kessler, David (HHS/IOS) <David.Kessler@hhs.gov>; O'Connell, Dawn (OS/ASPR/IO) <Dawn.Oconnell@hhs.gov>; Ashish.K.Jha@who.eop.gov <ashish.k.jha@who.eop.gov>; Salcido, Dori A. EOP/WHO <Dori.Salcido@who.eop.gov>; Barclay, Lisa L. EOP/WHO <Lisa.L.Barclay@who.eop.gov> Subject: Follow-up of our call Rob: The point that I was making during the zoom call was that we should get the data which I believe is available that looks specifically at the titer of neutralizing antibody against BA.5 induced by the bivalent BA.5 boost versus the title of the neutralizing antibody against BA.5 induced by the monovalent ancestral boost. The reason I say we need that data at hand is because if we are going to say that the BA.5 bivalent boost is far superior to the ancestral boost and that is the reason should wait for it until the Fall, we better make sure that we have data that substantiates that. This is important, since there are people out there saying that the BA.5 variant boost is really not that much different from the monovalent ancestral boost when you compare neutralizing antibody titers against BA.5. If the data show that the BA.5 bivalent boost is only marginally better than the ancestral monovalent boost, we should say that the bivalent is “somewhat” better and not make it look like the bivalent is a major advance. Having said all of that, I still believe that the scenario that we agreed upon as delineated in your not to me is sound. I just do not want us to oversell how good and different the bivalent boost will be because this will trigger pushback from the immunology community. Best regards, Tony ------ From: Koup, Richard (NIH/VRC) [E] <rkoup@mail.nih.gov> Sent: Tuesday, August 2, 2022 9:08 AM To: Fauci, Anthony (NIH/NIAID) [E] <afauci@niaid.nih.gov> Cc: Lane, Cliff (NIH/NIAID) [E] <clane@niaid.nih.gov> Subject: RE: Follow-up of our call Hi Tony, Sorry about not getting back to you earlier. I don’t know why I didn’t see this on my cell phone this morning. There is no question that the bivalent BA4/5 will probably do better against BA4/5 than the current ancestral boost. This is based upon circumstantial evidence, some of which is presented below. (Mouse immunogenicity, infection with omicron). The actual human data do not exist yet. The best we have is from John Beigel in the mix and match study, which shows only a marginal increase in BA4/5 neut titers, and which Peter Marks decided not to present at the VRBPAC, probably because the data did not support his desired outcome. I think the problem is that the FDA wants to say that they have a better vaccine coming. Instead, they should be saying that if people need vaccination now they should get the vaccine now. As with all vaccines, they will be rolling out updated vaccines as they become available and when there are data to support the change. People in need of vaccines now should not delay in hopes of getting a “better” vaccine. John Beigel can share his data with you. Best, Rick Richard A. Koup, MD Acting Director Chief, Immunology Laboratory Vaccine Research Center, NIAID, NIH Tel: 301-594-8585 Fax: 301-480-2779 rkoup@mail.nih.gov Had my twice daily follow up conversation with Kevin O'Connor regarding the condition of the president. The POTUS continues to remain with minimal an unchanged symptomatology characterized by fatigue and his usual post nasal drip related cough. It is still rather concerning that his CT levels are still very low and have not come back reflecting a very high viral load. We maintain the decision discussed above about not treating a lab test and only reinstituting therapy if he has an exacerbation of symptoms. I emphasized that he must be followed closely for return of significant sxs, which might trigger retreatment. August 3, 2022 Spoke with Kevin O’Connor. POTUS stable, but still Ag positive. ------------------------ Monkeypox spreading globally: My comment in NY Times article by Sheryl Stolberg: “Centering the response operation at the White House gives the administration more flexibility to coordinate efforts across a range of agencies that might be involved, including FEMA, the Health and Human Services Department and the Department of Homeland Security. It also creates a designated team that has no responsibilities other than to combat monkeypox — a move that makes sense”, said Dr. Anthony S. Fauci, Mr. Biden’s chief medical adviser. NY Times keeps hammering HHS for slow response in getting vaccines out to the community for monkeypox. Article by By Sharon LaFraniere, Noah Weiland and Joseph Goldstein: NYT: “U.S. Could Have Had Many More Doses of Monkeypox Vaccine This Year” I met with Rino Rappuoli in my office today. They are planning to make him the chief scientific officer of a pandemic preparedness program by the Italian government in Sienna. Rino wants me, either before or after I leave the NIH to help them in an official way to set-up their program. I gave an interview with Nate Silver about a book that he's writing about risks in society. Rand Paul together with Roger Marshal, Rick Scott, Josh Hawley, Ron Johnson is holding a “hearing” on origins with the witnesses: Richard Ebright (Lab Director Waksman Lab. Of Microbiology, Rutgers), Kevin Esvelt, (Assistant Professor of Media Arts and Sciences MIT Media Lab) and Steven Quay (CEO, Atossa Theapeutics) all totally non-credible. Angel Rasmussen is blasting them on twitter as hacks. Once per year the minority are allowed to call a hearing and so Paul et al are using this as a publicity stunt. The majority has not even showed up. It is a total farse. I got a follow-up from Chase Crawford from my legislative staff who listened to the hearing and the result was expected in which Ebright came out strong saying that we did do gain of function and that I lied Quay also said that. However Esvelt said that some may call this gain of function whereas other scientists would say it's not since gain of function is such an ill defined term. He came the closest to reality. The rest of them would just pounding away that NIH funded gain of function and it likely caused the outbreak and that I lied saying that we did not. COVID: August 4, 2022 The Wrap: Fox News host Tucker Carlson continued to imply that infectious disease expert and White House advisor Dr. Anthony Fauci somehow is responsible for creating the coronavirus pandemic during Wednesday night’s episode of “Tucker Carlson Tonight.” *****Critically important issue with CDC. Usual problem The CDC surprised us all by announcing that they are going to come out tomorrow with an updating of their guidelines across several areas including how one addresses getting back in to the public after a bout of COVID. The updated recommendations that they give are really inherently inconsistent. A number of things about them are troublesome, but the one that really stands out is the fact that they say that if you are infected you must isolate for five days and if you decide to test and have tests available you cannot go out into society with positive tests until after day 10. If you test negative for two days in a row within the 10 day period, you can go out into society but you still have to wear a mask until day 10. Importantly and disturbingly, if you test positive on day 10 since you have already reached the 10 day mark you can then still go out into society without a mask!!!! On the other hand, if you decide not to test at all, on day five you can go out into society with a mask and then on day 10 after day 10 you could take the mask off without knowing whether you're positive or not. This seems just so inherently inconsistent that it's going to be very difficult to explain that to the public. When Ashish heard that this was going to be announced tomorrow he demanded that Rochelle brief us on it tonight. When she did it became clear that the above contradictions existed (see above). Prior to that meeting, Rochelle called me up during the day and tried to explain what they were doing and it immediately didn't make any sense to me. I called up Cliff and he agreed with me. They seem to think that a positive test on day 10 doesn't necessarily mean that you're dangerous to go out into society because you should really be not infective after day 10 when in fact if you have a documented positive antigen test on day 10 all the data indicate that you definitely are transmissible since a positive antigen test means that you have replication competent virus. And so, the recommendations for those who cannot test because they don't have access to test are inherently contradictory to the recommendations for those who can test. This is going to drive Ron Klain completely crazy. In fact, Ashish called me up and said that Ron Klain is already so furious with Rochelle (even before he has heard this) that he fears that her job is in serious danger. Covid perhaps plateauing: POTUS continues to improve: William Patrick Connelly, Jr who threatened me and my family goes to jail. This is the guy yhat Brett Rowland tracked down. See Washington Post article: West Virginia man sentenced for threats against Fauci, officials Thomas Patrick Connally, Jr., was sentenced to more than three years in federal prison COVID cases: United States • Total Cases: 91,676,264, 7-Day average: 117,351 (-7.3%) • Total Deaths: 1,027,370, 7-Day average: 378 (-4.9%) • Total new hospital admissions: 5,078,893, 7-Day average 6,112 (-4.4) Worldwide [Source: WHO] - most recent day • Total Cases: 578,142,444 ( 972,954 new) • Total Deaths: 6,405,080 (2,491 new) PRESS: MSNBC Black/Hispanic Journalists Fireside chat with Alicia Menendez; August 5, 2022 Met with Hans Kluge – WHO Regional Director for Europe. He is seeking my advice on multiple issues such as COVID, MPX, and vaccine related polio. He said the Europeans rely very heavily on my opinion: Heard from Rochelle last night. Latest decision is that they wil hold off on the above announcement. Had meeting with Bruce Tromberg, Rochelle, Robbie Goldstein and CDC folks together with FDA folks (Rob Califf and team) and Steve Sha to try to get an agreement about guidelines for testing for isolation/quarantine when to stop isolation/masking, etc. We are coming to an agreement that is not perfect, but that is workable. Had another Zoom with the same team + Dawn O’Connell to explain to her our POTUS still positive on day 7 following rebound. ****Had a really major victory today resulting from a great collaboration between FDA, CDC, BARDA, me and John Beigel who was responsible for the design of a trial that would confirm that the study published in the journal Vaccine in 2015 by Frey et al and Bob Belshe showed that 1/5 the dose of the MVA monkey pox vaccine administered intradermally was as effective as a full dose of the subcutaneous administration. When we made this known to Bavarian Nordic (BN), lower level marketing people in the company objected strenuously, very likely because they saw this as a diminution in the need for full doses. Amazingly, they distorted the data and tried to marshal congressional support for blocking the use of the doses in the 1/5 dilution intradermally. This was an egregious attempt to interfere with the sound public health maneuver. To make a long story short when John Beigel showed all the data from the 2015 paper come it became clear that this was a very important way to expand the number of doses that were available. We finally got the leadership of BN to agree to continue to ship us the doses since their lower level people as indicated above were trying to block shipment in order to prevent us from distributing the vaccine in the 1/5 dilution. After much discussion with the FDA, we finally convinced them to issue an emergency use authorization (EUA) for the administration of the MVA vaccine in the1/5 intraderma; dilution. This is a major victory for the prevention of monkey pox because it turns 300,000 doses into 1.5 million doses and 1,000,000 doses into 5,000,000 doses. I consider this one of the major victories that I was a part of in trying to expedite the response to monkey pox. PRESS: WTOP Podcast with Luke Garrett & Megan Cloherty; CNN with Erica Hill; MSNBC with Andrea Mitchell; August 6, 2022 Continued drama now involving Larry Horowitz calling me up talking about how angry Ron Klain is at Rochelle for wanting to come out with a statement that the vaccines do not protect against infection at all. I have to look at the data but I think that although protection against true infection is low to modest at best, it is not zero and so I cannot figure out, and I am sure that this is what is bugging Ron, why the CDC needs to put that statement out now exactly at the time when we are pushing people to get the new BA.5 variant in early to mid-September. August 7, 2022 (Sunday) Long conversations with the CDC team (Sherri Berger; Rochelle), Steve Sha, Vivek, Kessler to get the wording correct on the condition to end isolation regarding testing and masking. August 8, 2022 For some time now the issue of ”Long COVID” has been gaining momentum with much frustration in the community since recent studies showed that up to 20% of people develop more COVID following infection. Senator Tom Kaine (D-VA) has been a strong advocate for support since he is suffering for well over a year from long COVID characterized by dysesthesias. The NIH has been given $1.15 Billion to study long COVID. However, I have been very disappointed in the initiatives that have been brought forth under the leadership of NHLBI with Gary Gibbons and Amy Patterson as well as Walter Koroshetz. Rachel Levine is now been given the leadership for this at HHS. Recent description: Politico: Tim Kaine has long Covid. That’s not moving Congress to act. While Kaine and other Democrats in the House and Senate are pushing for action, they have failed to gain meaningful momentum due to lack of GOP support. We had important conversations with activists James Krellenstein, Gregg Gonsalves, Peter Staley and Emily Bass regarding MPX vaccination. Peter alerted me today that James and other activists are concerned about misrepresenting the effective of the 1/5 approach to Jynneos (see above). I put together a hastily arranged Zoom at 12:45 PM to get us together and figure out what the problem is. The problem is that the activists are concerned that the data are not strong that 1/5 the dose of Jynneos intrasdermally (ID) will be protective. their argument is a bit inconsistent since the antibody titers induced by Jynneos ID are exactly equivalent to a full dose delivered subcutaneously (SC). The activists do not seem to be concerned about the efficacy of the SC dose, but they are concerned that we might be overselling the efficacy of the 1/5 dose. This may be an example of their making the perfect being the enemy of the good. It is much better to have some vaccine rather than no vaccine and so we needed to settle what their concern was since the FDA will be issuing tomorrow an EUA for the 1/5 ID dose. I got the activists on the zoom with Cliff, John Beigel, and me and we hashed it out. Peter Staley was agreeing with us and we finally got James and Gregg to come to the agreement that it is best to go ahead with the 1/5 ID program at the same time as trying to get data with a clinical trial that John will do as to the efficacy. That is better than having not enough doses and having a 5 minute notice getting the activist community together with my team to try and straighten out a potential disagreement. We had another zoom discussion with the HHS team led by Sherri Berger (CDC) to try to get the precise language for the CDC updating of their website discussion of the efficacy of the vaccine in preventing infection and transmission (see above). I believe that we got it right after a very good discussion among the group. The critical issue was to indicate that the vaccine protection against infection and transmission is only modest and diminishes with time. The concern was on the part of the White House that the CDC would say that it was zero. Now this is not really a consideration since the wording indicates in a positive way (by my suggestion) that although the protection against infection and transmission wanes overtime, that is a good reason why we encourage people to get the updated BA.5 bivalent boost. I believe we avoided a confrontation between the CDC and the White House which would have endangered Rochelle PRESS: Interview with Giuseppe Sarcina of Italian newspaper – Corrierre Della Sera; August 9-11, 2022 Global – 585,086,861/6,422,914; USA – 92,426,945/1,030,777 Cases and hospitalization plateauing but deaths still at ~300-400/day Had a wonderful trip to Seattle where I received the honorary “Hutch” award from the Fred Hutchinson Cancer Research center and the Seattle Mariners baseball organization. I did a fireside chat at the Medical Center with Larry Corey and then threw out the first pitch that evening for the Mariners and New York Yankees baseball game. In contrast to the disastrous pitch at the Washington Nationals game two years ago, this was a perfect pitch to the manager of the Mariners, Scott Servais, who served as the catcher. Sat in the “owner’s box” at the stadium and watched the game. Had a great conversation with Eddie Vedder (lead vocalist and guitarist for the rock band Pearl Jam.) and his wife Jill. Eddie reminds me a lot of Bono. One of the things that was striking about the evening at the ball game was that when they announced me as receiving the award with giant pictures of me on the photocam, I received a prolonged standing ovation from 45,000 people in the stands. Yet, the far right as exemplified by the newspaper The Washington Examiner put on YouTube the headline “Fauci booed at Mariners game. They put the microphone next to about five or six people out of 45,000 who were booing and saying I should go to jail and they completely ignored the 45,000 people that gave me a prolonged standing ovation. This is so exemplary of the distortion of reality by the far right. Monkeypox continues to surge: August 12, 2022 Deaths seem to be up a bit at around 400/day! August 13, 2022 More drama with regard to the CDC and Rochelle Walenski. After much going back and forth between the CDC and the other docs including me, Vivek, Steve Cha, and to some extent David Kessler, we thought we had gotten them pulled back from making the statement that the vaccines were not effective at all in preventing infection and transmission. The reason this is an issue is that if they came out with that statement, which in fact is not entirely true since there is some degree of modest but declining protection as you would expect, then this would conflict with the statement and effort of recommending that people get the updated bivalent BA.5 vaccine in September. In addition, it would undermine the DoJ’s efforts at mandates for vaccines under certain circumstances. In any event, the CDC agreed to pull back on the statement of absolute lack of efficacy of vaccines against infections and transmission and take a more measured approach of saying that the vaccines provides only modest and waning efficacy against infection and transmission and that is why we should heed the advice of getting the updated booster in Sept. However, although they did this on their website, the MMWR that cam out yesterday had the same original damning language. When Larry Horowitz and Ashish noticed this, Larry went off the wall and in a somewhat agitated manner called me up this AM and said that this is the last straw and he was sure that when Ron Klain gets back from Spain this weekend he would fire Rochelle. Ashish was more measured and seems to have come to the conclusion that sooner or later (maybe not right now) Rochelle would have to go. Let us see what happens…..probably nothing August 14, 2022 Had a wonderful dinner last night at the extraordinary home of Adrienne Arsht at 9 Chevy Chase Circle, Chevy Chase, MD. Guests included Alexandra Villard de Borchgrave (Chairman. Light of Healing Hope Foundation and former war correspondent), Jonathan Capehart (MSNBC and Washington Post), Pamela Melroy (former astronaut and Deputy Administrator, NASA), Sen Bill Nelson and Wife Grace (Administrator, NASA), Vivian Salama (WSJ – war correspondent), Jonathan Goodrich (Attorney, Interior Department). 35,000 cases of MPX globally: August 15, 2022 Great disparity of COVID deaths comparing USA and other countries: PRESS: The Shade Room (Online streaming); The Grio TV; August 16, 2022 I had a very important and moving conversation with Ron Klain in his West Wing Office today at 11:45 AM (bright, sunny, mild day). I announced to Ron that I would be stepping down from all of my positions including chief medical advisor to the President. I will make the announcement next week and my date for stepping down will be sometime in December of this year. One of the concerns that Jeff Zients and I had would be that Ron would want to push back on my leaving giving all the trouble that he's having with the CDC. However, he somewhat surprised me by saying that his instinct would be to push strongly to convince me not to leave, given that he considers me “one of the most important public servants in the history of the country” given that I have saved millions of lives over the last several years. He would be almost embarrassed trying to convince me to change my mind about something that I obviously have thought about for some time and that I thoroughly deserve. He went on to say so many nice things that I was embarrassed. He said that he considered it a major privilege in his life to have had the opportunity to work with me both during the Obama administration with Ebola and now with COVID and monkey pox. He said that he would arrange tomorrow for me to either see the president if the president comes to the White House tomorrow; if he does not come to the White House then arrange a phone call between me and the president tomorrow. It was a most moving meeting the extraordinary praise shown towards me and the sincere appreciation for all that I have done for the country and the world during my long career. He sounded extremely sincere. --------------------------------------------------------------------------------- NIH will write a Science Forum on NIH accomplishments in COVID. Below is a preliminary outline of what will be said. I added a mention of the role of the COVID - 19Prevention Network (CoVPN) in the clinical trials of all the vaccines: Key COVID-19 Milestones – NIH High-level COVID-19 Accomplishments January 10: The genetic sequence of the SARS-CoV-2 virus was released, which was used as the blueprint for the rapid development of the mRNA COVID-19 vaccines. Blurb: SARS-CoV-2 genetic sequence released Image: Ask Palladian for timeline image January 13: NIH and Moderna finalized the design of a vaccine candidate and began working to produce it. Blurb: NIH/Moderna finalized COVID vaccine candidate design Image: https://www.flickr.com/photos/nihgov/50047466123/in/album-72157713108522106/ January 31: The United States declared COVID-19 a public health emergency. Blurb: U.S. declared COVID-19 a public health emergency February 25: NIH launched the Adaptive COVID-19 Treatment Trial (ACTT) series of studies with a randomized, placebo-controlled clinical trial to evaluate the safety and efficacy of the antiviral remdesivir in adults hospitalized with COVID-19 (ACTT-1). Press release Blurb: NIH launched trial of the antiviral remdesivir Image: https://www.shut terstock.com/image-photo/remdesivir-covid19-liquid-medicationbackground-1706609728 March 11: The World Health Organization declared COVID-19 a pandemic. Blurb: WHO declared COVID-19 a pandemic March 16: The Phase 1 clinical trial started for the investigational vaccine, known as mRNA-1273, codeveloped by NIH and Moderna. Press release Blurb: NIH/Moderna COVID vaccine Phase 1 clinical trial started Image: 3.16.20 Phase 1 Moderna April 17: NIH launched the Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV) initiative, a public–private partnership focused on developing treatments and vaccines for COVID-19. ACTIV streamlined the process for adding new agents into trials and rapidly deployed existing NIH networks of more than 620 trial sites across the U.S. and internationally. The initiative evaluated over 800 therapeutic agents and prioritized 33 for inclusion in ACTIV master protocols. Six of these agents have shown compelling evidence of benefit in randomized clinical trials. Press release Blurb: NIH launched ACTIV, a public-private partnership to develop treatments and vaccines Image: 4.17.20 ACTIV April 21: After convening a panel of academic and government experts to critically review and synthesize available data from clinical trials and other study reports, the first NIH COVID-19 Treatment Guidelines were published to provide clinicians with guidance on how to care for patients with COVID-19. The panel has issued more than 50 updated editions since April 2020 and the guidelines have been visited more than 30 million times. Press release Blurb: NIH published the COVID-19 Treatment Guidelines April 29: NIH launched the Rapid Acceleration of Diagnostics (RADx) initiative to speed innovation leading to reliable diagnostic testing. Press release Blurb: NIH launched RADx initiative to speed innovation in diagnostic testing Image: 4.29.20 RADx May 22: Preliminary peer-reviewed data from the ACTT-1 trial indicated that the antiviral drug remdesivir is safe and improved clinical outcomes for hospitalized adults with COVID-19. Press release Blurb: Antiviral drug remdesivir found safe and effective. Image: https:// www.shutterstock.com/image-photo/medication-prepared-people-affected-bycovid19-1731814354 May 24: NIH created a public COVID-19 OpenData Portal to openly and quickly share COVID-19-related drug repurposing data and COVID-19 variant-specific effects against all approved drugs. It was a key resource for the ACTIV Tracking Resistance And Coronavirus Evolution (TRACE) efforts. Blurb: COVID-19 OpenData Portal shares data on drug repurposing and variant effects with drugs. Image: 5.20 COVID Data Portal variants July 8: NIH launched the COVID-19 Prevention Network (COVPN), a clinical trials network to test COVID-19 vaccines and other prevention tools. Press release Blurb: NIH launched COVID-19 Prevention Network to test COVID vaccines and treatments. July 27: The Phase 3 clinical trial started for the investigational vaccine mRNA-1273, co-developed by NIH and Moderna. The trial enrolled approximately 30,000 adult volunteers who did not have COVID-19. Press release Blurb: NIH/Moderna COVID vaccine Phase 3 clinical trial began, enrolling ≈30,000 adult volunteers. Image: https://www.shutterstock.com/image-photo/covid19-vacci nation-asian-male-patientgetting-1831245058 August 4: NIH launches the first ACTIV clinical trials to test the safety and efficacy of treatments both for mild and moderate COVID-19 patients and for patients hospitalized with COVID-19. ACTIV-2 press release, ACTIV-3 Press Release Blurb: First ACTIV trials to evaluate the safety and efficacy of COVID therapeutics begin. Image: 8.4.20 ACTIV trials September 16: Recognizing the need to ensure inclusive participation in vaccine trials, NIH launched Community Engagement Alliance (CEAL) Against COVID-19 Disparities. CEAL provided outreach and engagement opportunities in racial and ethnic minority communities disproportionately affected by the COVID-19 pandemic. (In 2021, NIH supplemented the effort with $29 million in funding from the American Rescue Plan). September press release Blurb: NIH launched CEAL to ensure diversity in vaccine trials and reach out to disproportionately affected communities. Image: 9.16.20 CEAL September 30: NIH expanded research to improve COVID-19 testing among underserved and vulnerable populations as part of the RADx initiative, the RADx Underserved Populations (RADxUP) program. Press release Blurb: NIH expanded RADx initiative to improve COVID-19 testing in underserved populations. Image: 9.30.20 RADx UP October 2: Quidel Sofia 2, the first point-of-care test to detect COVID-19 supported by NIH’s RADx initiative, receives emergency use authorization (EUA) from the FDA. Blurb: First RADX-supported COVID test received EUA. Image: 2.2.20 Test Kit December 11: The ACTT-2 trial found that baricitinib, an anti-inflammatory drug, reduced time to recovery for people hospitalized with COVID-19 who were treated with remdesivir. Press release Blurb: Trial results showed remdesivir in combination with anti-inflammatory drug baricitinib reduced hospital recovery time Image: https://www.shutterstock.com/image-photo/medication-prepared-peopl e-affected-bycovid19-1970653763 December 15: The first over-the-counter COVID-19 test, developed with support from NIH’s RADx initiative, received an FDA emergency use authorization. Blurb: First RADx-supported over-the-counter COVID-19 test received EUA. Image: 12.15.20 RADx OTC December 18: FDA authorized the NIH-Moderna vaccine for emergency use for people 18 years of age and older. The NIH-Moderna vaccine went on to receive authorization for various age groups and is now available for everyone over the age of 6 months. Blurb: FDA grants EUA to NIH/Modera vaccine Image: https://www.shutterstock.com/image-illustration/cracow-malopolskie-poland-october10-2021- 1891094320 January 5: NIH’s RADx launched an interagency variant task force to evaluate the impact of new variants on the performance of all authorized point of care and over the counter diagnostics, as well as tests in pre-authorization review. This ongoing partnership with FDA informs regulatory decisions, RADx investments, manufacturer designs, and government procurements. Blurb: Interagency variant task force launched to evaluate impact of variants on COVID tests Image: 1.5.21 variant tests January 20: The ACTIV Tracking Resistance and Coronavirus Evolution (TRACE) initiative launched. It is focused on identifying emerging variants of SARS-CoV-2. TRACE aims to prioritize which viral variants should be studied to determine the effectiveness of vaccines and therapeutics, coordinate data sharing, and report results regularly to allow confident decision making by the U.S. Government, health professionals, and pharmaceutical organizations. Blurb: The ACTIV Tracking Resistance and Coronavirus Evolution (TRACE) initiative began to identify, evaluate, and report on emerging variants. Image: https://www.flickr.com/photos/nihgov/52129878815/in/album-72157713108522106/ February 27: FDA authorized the Janssen COVID-19 vaccine for emergency use. NIH supported the development of the single-shot vaccine, which does not require special refrigeration. Blurb: FDA grants EUA to Janssen COVID vaccine Image: https://www.shutterstock.com/image-photo/izmir-turkey-january-17-2021-coronavirus1925271767 March 31: In collaboration with the CDC, NIH launched an innovative community health initiative called “Say Yes! COVID Test” for counties in North Carolina and Tennessee to determine if frequent self-administered COVID-19 testing can help residents reduce community transmission. Say Yes! COVID Test went on to distribute 6.8 million rapid tests that were developed with RADx support in numerous targeted areas throughout the country. Press release Blurb: NIH launched community health initiative Say Yes! COVID Test to assess frequent selftesting. Image: 3.31.20 Say Yes COVID Test April 15: NIH announced the Safe Return to School Diagnostic Testing Initiative, which awarded up to $48 million over several months to fund projects to build evidence on safely returning students, teachers, and support staff to in-person school in areas with vulnerable and underserved populations. (Additional funds issued July press release). April press release Blurb: NIH launched Safe Return to School Diagnostic Testing Initiative Image: https://www.shutterstock.com/image-photo/side-view-portrait-yo ung-africanamericanman-1967011807 August 4: Part of the ACTIV initiative, an NIH-supported clinical trial showed that treating moderately ill hospitalized COVID-19 patients with a full-dose blood thinner reduced their need for organ support, such as mechanical ventilation, and improved their chances of leaving the hospital. Press release Blurb: ACTIV-4 clinical trial found that a full-dose blood thinner improved outcomes for moderately ill hospitalized patients. September 15: NIH announced $470 million in funding for a nationwide study of tens of thousands of people to support research on the long-term effects of COVID-19 called the NIH REsearching COVID to Enhance Recovery (RECOVER) Initiative. Press release Blurb: NIH funded REsearching COVID to Enhance Recovery (RECOVER) Initiative to study COVID’s long-term effects. Image: Can we use this image from the timeline? NIH Strategic Response to COVID-19 | NIH COVID-19 Research October 9: Brii Biosciences filed for an FDA emergency use authorization for the ACTIV-3 monoclonal therapeutic antibody combination amubarvimab/romlusevimab that demonstrated clinical effectiveness in preventing progression of disease for mild to moderate COVID-19 patients. Blurb: ACTIV-3 trial found monoclonal therapeutic antibody combination effective in preventing disease progression in mild to moderate patients. October 27: NIH announced the Independent Test Assessment Program (ITAP), which established an accelerated pathway to support FDA evaluation of tests with potential for large-scale manufacturing. The program is an extension of the NIH RADx initiative. In less than two months, the first two over-the-counter tests that went through the ITAP accelerated pathway received EUAs, contributing millions of tests per month to the domestic supply. Press Release Blurb: NIH announced ITAP, an accelerated pathway to support FDA evaluation of COVID tests. Image: https://www.shutterstock.com/image-photo/portland-usa-feb-5-2022-closeup2118748202 January 26: The NIH clinical trial on booster doses of different COVID-19 vaccines to determine the safety and efficacy of mixed vaccine regimens found that all combinations of primary and booster vaccine resulted in increased neutralizing antibody levels. The data strongly suggest that mixed COVID-19 vaccines could increase protective efficacy against symptomatic SARS-CoV-2 infection. Press release Blurb: NIH clinical trial data strongly suggest that mixed COVID-19 vaccines could increase protective efficacy against symptomatic SARS-CoV-2 infection. Image: FC getting his vaccine? https://www.flickr.com/photos/nihgov/50747919667/in/album72157717478402642/ OR https://www.shutterstock.com/image-photo/black-teen-girl-showsvaccine-mark-1899903244 June 2: Topline results from the ACTIV-1 Immune Modulators clinical trial showed that immune modulator drugs improved survival for people hospitalized with COVID-19. Press release Blurb: ACTIV-1 immune modulators trials meet secondary endpoint/improved survival July 20: The CDC recommended that Novavax’s COVID-19 vaccine be used as another primary series option for adults in the United States ages 18 years and older. NIH supported development of the Novavax vaccine, NVX-CoV2373, and is studying it in the “mix & match” trial, where adult volunteers who have been fully vaccinated against COVID-19 receive booster doses of different COVID-19 vaccines to determine the safety and immunogenicity of mixed boosted regimens. Blurb: CDC recommended Novavax vaccine for adults Image: https://www.shutterstock.com/image-photo/novavax-coronavirus-vaccine-d octorsnurses-hands-1904970715 April 29: Two years after its launch, RADx-supported companies increased cumulative U.S. capacity by >2.5 billion tests, helping drive a national paradigm shift where over the counter (home) and point of care tests become the dominant form of testing. Blurb: After two years, RADx-supported companies increased U.S. capacity by >2.5 billion tests Image: 4.29.22 RADx test capacity Monkey pox cases in the UK starting to trend downward: August 17, 2022 E-mail from Ron Klain after I met with him and asked to speak with the POTUS: From: Klain, Ronald A. EOP/WHO <RK.COS@WHO.EOP.GOV> Sent: Wednesday, August 17, 2022 10:19 AM To: Fauci, Anthony (NIH/NIAID) [E] <afauci@niaid.nih.gov> Cc: Goepfert, Stephen M. EOP/WHO <Stephen.M.Goepfert@who.eop.gov> Subject: [EXTERNAL] RE: Thank you Tony, Sad for me, sad for America, but no one has earned it more. The President is anxious to speak with you today – he travelled to Delaware last night. I am copying Stephen Goepfert here, who is with the President in Wilmington, to arrange the timing for your call. Ron I just had a wonderful conversation with President Biden. He called me up (started the conversation with “Hi, Joe here….”) and told me how much he admired me and how much of a pleasure it was to work very closely with me over the past year and three quarters. He told me that he wanted to guarantee that I would have as much protection as I need for as long as I need it. I told him how much I enjoyed working with him and that I was actually thinking of leaving government at the end of the last administration. However, when he became president and offered me the job as his chief medical advisor it was a job that I absolutely could not refuse. I also told him that working with him over the last two years was the capstone of my career. He was quite moved by that and seemed to be very pleased with hearing that. PRESS: Interview with Rolling Stone (Matt Sullivan) regarding story on Steph Curry August 18, 2022 Global – 590,659,276/6,440163; USA – 93,124,238/1,034,118 ---------- CDC (Rochelle Walensky) comes out with a strong statement of “mea culpa” admitting that the CDC is broken and has failed terribly in the response to the COVID pandemic. LONG OVERDUE! CDC Moving Forward Fact Sheet. NY Times (La Franiere and Weilland): Walensky, Citing Botched Pandemic Response, Calls for C.D.C. Reorganization Among other flaws, public guidance during the coronavirus pandemic was “confusing and overwhelming,” the agency said. ------------------------ RFK, jr continues his destructive ways: Ars Technica: Anti-vaccine activists giddily celebrate as poliovirus spreads in NY -------- I defend CDC and Rochelle regarding their admission of their botched response by commending them for honesty and trying to reform. I did this on MSNBC with Andrea Mitchell. PRESS: MSNBC with Andrea Mitchell; Podcast “In the Bubble” with Any Slavitt; CNN – “The Situation Room” with Wolf Blitzer August 19, 2022 Cases seem to be plateauing throughout the country with some exceptions. Perhaps we are coming into a downswing as we enter the Fall PRESS: Interview with Marissa Evans of LA Times on racial disparities in MPX; WTOP Radio; August 20, 2022 Had my usual every three-week zoom meeting with Drs. Li and Hellmann. I explained to them that as of Monday at 11:00 AM when I made the announcement of my stepping down from the NIH, I will enter a new chapter in my career and in my life. There's obviously stress and anxiety associated with this decision. However, there's also excitement for the new adventure and unknown. Had a wonderful Zoom meeting with Nathan Chen at 12:30 PM. He had been wanting to meet me for some time now and we finally connected by zoom. He was so modest and nice and kept expressing what an honor it was to meet me and speak with me. He is going into his third year at Yale having taken off most of two years to practice for the Olympics where he gave probably the most historically perfect performance to win the gold medal. He plans to go to medical school after he graduates. I was struck by his maturity and modesty when I asked him why he was interested in medicine. He said all his life he had been practicing to make himself better and better and better, but it was all about himself. Now he wants to do something that has a positive impact on society and on other individuals. The sign of a very mature young man. I had a very long (1 hour and 10 minue) exclusive interview with Yasmeen Abutaleb (Washington Post) concerning my upcoming stepping down from Government service. Embargoed until Monday at 11:00 AM August 21, 2022 Interesting trivia (Sports Business Journal): Dr. Anthony Fauci’s First Pitch Sets Baseball Card Record By Tom TaylorJuly 28, 2020 • • • Topps has issued a trading card of Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, throwing out the first pitch of the MLB season last week. The card was only available for 24 hours, under the company’s Topps Now brand, but it set a new record with 51,512 sold. August 22, 2022 TODAY IS THE DAY! I announce that I will be stepping down from the NIH as well as from my position as chief medical adviser to the president effective December, 2022. There has been a literal avalanche of positive feedback about my announcement with hundreds and hundreds of texts and emails of congratulation and praise for me. President has come out with a statement as have a number of other prominent individuals. See the president statement below: Statement from President Joe Biden on the announcement of Dr. Anthony Fauci’s Departure from NIAID AUGUST 22, 2022•STATEMENTS AND RELEASES During my time as Vice President, I worked closely with Dr. Anthony Fauci on the United States’ response to Zika and Ebola. I came to know him as a dedicated public servant, and a steady hand with wisdom and insight honed over decades at the forefront of some of our most dangerous and challenging public health crises. When it came time to build a team to lead our COVID-19 response – in fact, in one of my first calls as President-elect – I immediately asked Dr. Fauci to extend his service as my Chief Medical Advisor to deal with the COVID-19 crisis our nation faced. In that role, I’ve been able to call him at any hour of the day for his advice as we’ve tackled this once-in-a-generation pandemic. His commitment to the work is unwavering, and he does it with an unparalleled spirit, energy, and scientific integrity. Dr. Fauci has served under seven Republican and Democratic Presidents during his career, beginning with Ronald Reagan. He was awarded the Presidential Medal of Freedom in 2008 under President George W. Bush. For almost four decades, he has served as Director of the National Institute of Allergy and Infectious Diseases, helping our country navigate health crises ranging from HIV/AIDS to COVID-19. Because of Dr. Fauci’s many contributions to public health, lives here in the United States and around the world have been saved. As he leaves his position in the U.S. Government, I know the American people and the entire world will continue to benefit from Dr. Fauci’s expertise in whatever he does next. Whether you’ve met him personally or not, he has touched all Americans’ lives with his work. I extend my deepest thanks for his public service. The United States of America is stronger, more resilient, and healthier because of him. Statement of Sec. Becerra: Statement by HHS Secretary Xavier Becerra on Upcoming Departure of Dr. Anthony S. Fauci Today, Anthony S. Fauci, M.D. announced he is stepping down in December 2022 from the positions of Director of the National Institute of Allergy and Infectious Diseases (NIAID) and Chief of the NIAID Laboratory of Immunoregulation, as well as Chief Medical Advisor to the President. U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra issued the following statement: “This is a decision we all knew would eventually come but hoped never would. As HHS Secretary, I am privileged to know Dr. Fauci professionally and personally and deeply admire his decades of public service that have undoubtedly improved the health of millions of people globally. When I arrived at HHS, the world was one year into the COVID-19 pandemic. I quickly came to rely on Dr. Fauci’s wisdom and counsel in our response, and along with his scientific acumen, I treasure his ability to break down complex science in simple terms to the American people to save lives. “His selfless passion to bring hope and healing to people fighting for their health knows no bounds. In fact, Dr. Fauci’s pioneering approach to tackle public health decades ago included a critical role in our nation’s domestic and international response to HIV/AIDS, ultimately helping create the President’s Emergency Plan for AIDS Relief. “I will be sorry to see Dr. Fauci depart in December, but I wish him all the best in his future endeavors and look forward to witnessing his next chapter.” Larry Tabak statement: Statement from Lawrence A. Tabak, D.D.S., Ph.D., on the departure of Anthony S. Fauci, M.D. Anthony S. Fauci, M.D., Director, National Institute of Allergy and Infectious Diseases Today marks the end of an era with the announcement by Anthony S. Fauci, M.D., that he will be stepping down as the Director of the National Institute of Allergy and Infectious Diseases (NIAID), Chief of the NIAID Laboratory of Immunoregulation, and Chief Medical Advisor to President Biden. Tony’s departure will cause a tectonic shift in the modern history of the National Institutes of Health. He is the model public servant — dedicated and selfless, and a brilliant scientist and physician who is passionate about developing treatments and cures for those who are sick and suffering. He has dedicated his life’s work to advancing knowledge about the causes of complex diseases ranging from HIV to asthma, rarely satisfied with anything less than a cure. For Tony, it’s personal. He works tirelessly on behalf of all patients, often at great personal expense, and always bringing his Brooklyn tenacity to the fight. I know of no one more dedicated than Tony to the mission of the NIH and the health of the American people. Tony’s NIH career spans 54 years, 38 of those leading NIAID, advising seven U.S. Presidents, and reassuring the public as America’s doctor during outbreaks of infectious diseases, from HIV to Ebola to COVID-19. Without exception, he is always guided by the science. It’s been an extraordinary privilege and honor to have worked by his side and to have learned so much from him — I will miss him greatly. But I also look forward to seeing what Tony will do next. I have no doubt that he will continue to have an enormous impact on the world. Lawrence A. Tabak, D.D.S., Ph.D. Performing the Duties of the NIH Director Ashish K. Jha, MD, MPH @AshishKJha46 Tony Fauci is the most consequential physician scientist of the past half century Having served 7 Presidents through HIV/AIDS, Anthrax, H1N1, Ebola, Zika, and of course COVID Thousands consider him their mentor, including me Grateful for your service to our country Dr. Fauci Ronald Klain @WHCOS I cannot think of a public servant who has done as much to save as many lives for as long a period as Dr. Tony Fauci. And he is a gem of a person. Tweet See new Tweets Conversation Barack Obama @BarackObama I will always be grateful that we had a once-in-a-century public health leader to guide us through a once-in-acentury pandemic. Few people have touched more lives than Dr. Fauci – and I’m glad he’s not done yet. PRESS: Beautiful article in the Washington Post by Yasmeen Abutaleb: Fauci plans to step down in December after half a century in government By Yasmeen Abutaleb Updated August 22, 2022 at 2:20 p.m. EDT|Published August 22, 2022 at 11:00 a.m. EDT NY Times by Cheryl Gay Stolberg: Fauci Says He Will Step Down in December to Pursue His ‘Next Chapter’ MSNBC with Rachel Maddow (Rachel was extremely laudatory) August 23, 2022 NY Times Opinion piece by Gregg Gonsalves is really nice: OPINION GUEST ESSAY Anthony Fauci’s Retirement Marks the End of an Era , 5:00 a.m. ET PRESS: WTOP with Nick Iannelli; CNN “New Day” with Kaitlan Collins; WGN Bob Sirrott Show (Chicago Radio); Canadian Broadcasting Corporation (CBC Radio); FOX News “Live” with Neil Cavuto; BBC Newsnight TV; NPR “All Things Considered” with Mary Louise Kelly August 24, 2022 The number of texts and e-mail of thanks and praiseupon the announcement of my stepping down are stunning, ranging in the several hundreds. I am getting truly exhausted trying to answer all of them. ----- NEWS CLIPPING — WASHINGTON POST — CONDENSED (1 SOURCE PAGE) “Jill Biden rebounded after a course of Paxlovid just the way I did!! -------- Cases slowly (very slowly) coming down: Very nice article about me and retirement in Nature: ‘He has saved countless lives’: US…” Perspective by Robin Givhan Senior critic-at-large|Follow August 23, 2022 at 7:10 p.m. EDT With all of the praise and adulation that I'm getting from so many sources, the far right GOP keep saying that they're going to investigate me after I stepped down even though there's absolutely nothing to investigate me about; they are looking very mean spirited. August 25, 2025 Interesting cartoon in Washington Post concerning my stepping down: We are really not coming down in cases/hospitalizations/ or deaths very sharply. We seemed to have hit a plateau with a very slight trend downward. United States • Total Cases: 93,777,133, 7-Day average: 90,676 (-6.7%) • Total Deaths: 1,037,281 7-Day average: 390 (-11.6%) • Total new hospital admissions: 5,198,924 7-Day average 5,614 (-6.6%) Worldwide [Source: WHO] - most recent day • Total Cases: 596,119,505 (829,163 new) • Total Deaths: 6,457,101 (2,564 new) ------- In Science indicating how Tucker Carlson was ranting about me after hearing of my stepping down: Almost everything Tucker Carlson said about Anthony Fauci this week was misleading or false Science fact-checks the Fox host’s rant against “Saint Tony,” who announced his retirement on Monday • 25 Aug 2022 • 6:10 PM By Jon Cohen Tweet from Bill Gates: Tony, you were an amazing public servant long before COVID-19 struck – and now you are a hero to millions of people, including me. npr.org Fauci to step down in December after decades of public service Dr. Anthony Fauci helped guide the U.S. through the COVID crisis, and earlier in his career played a key role in the response to AIDS. He has served under seven presidents. The Soapbox Quoting the New Republic: We May Never See Another Lifelong Public Servant Like Anthony Fauci In a distinguished government career spanning more than half a century, he expertly steered America through two devastating pandemics. But given how Republicans have maliciously attacked him, why would anyone want to follow in his footsteps? PRESS: Bloomberg News with David Westin; Spectrum News Los Angeles with Giselle Fernandez; August 26, 2022 Dan Diamond story in the Washington Post: Health House panel: Trump sought to pressure FDA on covid vaccines, treatment The report offers fresh details about that campaign and how it rattled agency officials. This panel report documents the attempts of Peter Navarro and Hatfill to undermine me and get me fired since I pushed back on Hydroxychloroquine: https://coronavirus.house.gov/sites/democrats.coronavirus.house.gov/files/2022.08.24%20The%20Tru mp%20White%20House%E2%80%99s%20Relentless%20Attacks%20on%20FDA%E2%80%99s%20Corona virus%20Response.pdf PRESS: London Times Radio with Carole Walker; Gray TV interview; August 29, 2022 Previous 2 days my daughters and partners were here for the weekend. Very slow with regard to COVID. Clearly people like John Moore (who is the most reasonable) and Paul Offit (not so much) are pushing back on the drive to boost people in September with the “updated” BA.5 bivalent since they say that boosters are not needed (Offit) or that the original vaccine is as good as the bivalent (Moore) Ashish Jha called me today asking advice on when to give the POTUS the bivalent BA.5 boost. I told him 3 months after his recent infection. Same for the First Lady. ------- Monkeypox cases starting to plateau – probably a combination of behavioral modification + vaccine availability: Statement from Tedros: Then, on my friend, Tony, Tony Fauci. We have been friends for many years. I respect him dearly and greatly. He’s an incredible scientist, amazing human being and congratulations to him for all the job that he has done. I know retirement doesn’t mean he will stop working. Retiring for him is like changing a tyre, meaning another mission, and I look forward to continue working with him closely through other things he will, I know, continue to do. So, I wish him all the very best. Tony is so special and everybody knows, I think. With COVID, we are still doing worse with deaths than any other country: PRESS: Interview with Swiss newspaper -Finanz und Wirtschaft; August 30, 2022 USG (FDA) getting ready to issue EUA for BA.5 bivalent boost PRESS: JAMA Interview with Editor-in-Chief Kirsten Bibbens-Domingo; August 31, 2022 NY Times Opinion piece by Ari Schulman (rather critical of me): Why Many Americans Turned on Anthony Fauci

There is a very interesting situation that has emerged from the White House particularly involving Ron Klain and Ashish Jha in the context of the BA.5 bivalent booster shot. The FDA has authorized and the CDC has approved the use of the bivalent BA.5 booster for individuals 12 years of age and older. The concern of Ron and Ashish is that we need to sell it to the American people in a manner in which they feel this is something “new and different” that they really should partake of. However, even though we all feel that people should be getting a booster shot, to sell it as something that is going to be much better than the prototype boost would be somewhat of a stretch since although one can project that there would be an advantage of a variant specific boost, early indications from an immunological standpoint indicate that although it is likely going to be somewhat better it is not going to be a lot better. In addition, there is the push back from some in the scientific community that we are doing this with very little human clinical data. One can extrapolate from clinical immunological data using a BA.1 bivalent variant boost where the data are plentiful. In addition, we have extraordinary amount of data on the safety of using this type of vaccine in billions of doses and billions of people worldwide. Also, the preclinical mouse data with the specific BA.5 bivalent vaccine indicates that it gives an anti-BA.5 response much higher then the prototype vaccine does. Ron and Ashish are struggling with ways to sell this and the latest thing they're trying to do is to say that it could be part of a yearly booster similar to what we do with flu. All of this is fine except that they're straining to get a message so that a lot of people will get boosted when in fact this is unlikely going to be the case. No matter what we say, the message will not change the facts and we're getting close to the line of overselling something. In one instance today, Ron was upset that Vivek had said that this was an updated “boost” instead of an updated “vaccine” because he felt people don't want this to be yet again another boost whereas if we sell it as an updated vaccine in the context of making it a yearly occurrence then that would be perceived as something that is truly new. PRESS: NPR with Rob Stein; MSNBC with Yasmeen Vossoughian; CNN with Ericka Hill; PBS NewsHour with Judy Woodruff;

I had to help clean up a bit of a mess today when the President casually said on a “60 Minutes” interview that the pandemic was over. I had a number of press today and certainly I got asked the question particularly on NPR about how this relates to the fact that all of us have been saying that we are still in the middle of a pandemic and 400 people are dying each day. I gave the explanation that it really is a matter of semantics and that the president was referring to the fact that the fulminant stage of the outbreak is no longer present since we were experiencing 800,000 cases a day and over 3000 deaths per day several months ago and the situation is very different now. However, I did emphasize that we are still in the middle of a pandemic. It is likely that there will be another wave of infections in November: Variant report 2022-09-14 A variant wave is likely to start in at most 3 months The BA.2.75 sublineage BA.2.75.2 (S:346T, S:486S, S:1119N) currently doubles in share every week (+80120%). It made up between 0.1 and 0.5% in samples from two weeks ago in Europe (in Asia, North America and Oceania, the share is higher at between 0.5-5%). • Global Cov-Spectrum query • Europe Cov-Spectrum query If this growth trend continues, this variant will dominate in about two months. At this point, the growth advantage would manifest in increased overall growth in incidence and a variant wave would start around November - on top of the expected seasonal acceleration of transmission. The growth advantage over resident BA.2 or BA.5 lineages is of the same order of magnitude as was the case when BA.5 displaced BA.2, which was sufficient to cause a summer wave. Currently, BA.2.75.2 is the fastest growing lineage with more than 350 sequences available. The rest of this report will focus on other lineages that may end up growing faster than BA.2.75. PRESS: Canada TV “The Agenda” with Steve Paikin; NPR “The World” with Marco Werman;Podcast with Steve Morrison at CSIS; MiddleEast Broadcast Interview (TV); Rural Health Matters TV with Dr. Jeffrey Gold;

• Typical media distortions. Vivek Murthy was on MSNBC with Morning Joe and they showed a clip of POTUS saying that the pandemic was “over” and then they showed immediately after a short clip of “part” of my interview with Steve Morrison in a CSIS podcast of my saying: FAUCI [clip]: “we are not where we need to be if we're going to be able to quote live with the virus because we know we're not going to eradicate it. we only did that with one virus, which is smallpox, and that was very different. because smallpox doesn't change from year to year or decade to decade or even from century to century.” As expected this created somewhat of a disturbance with the meme being pitting me against the president of the United states. Rather typical press nonsense. The POTUS is getting pushback and criticism in that he has inadvertently undermined out attempts to get more money from the Congress for COVID since the GOP will now quote him as saying the pandemic is “Over”. I have been out there explaining that the POTUS meant that the “fulminant” nature of COVID when we were getting 3 to 4000 deaths per day is now behind us, whereas now even though we are at an acceptably high level of three to 400 deaths per day, it is still much better than it was many months ago. It is as good an explanation as any to get us back on track with the world realizing that we still have to take COVID very seriously with the current toll per day as well as the possibility that we might wind up getting another variant such as BA.2.75.2 in November. Went to the Kennedy Center last night to participate in the presentation to Cliff Lane of the Paul Volcker Career Achievement Medal (the “Sammies”) PRESS: Lancet Podcast interview; Podcast “Inside the Issues” with Alex Cohen (California); TED interview (Fireside Chat with David Biello);

United States • Total Cases: 96,052,716 7-Day average: 47,112 (-13.1%) • Total Deaths: 1,053,173 7-Day average: 344 (-6.7%) • Total new hospital admissions: 5,353,767 7-Day average 3,733 (-7.4%) Worldwide [Source: WHO] - most recent day • Total Cases: 613,942,561 (460,497 new) • Total Deaths: 6,520,263 (1,248 new) We had the deputies meeting in the SCIF today on Ebola in Uganda led by the White House National Security Council. This was preceded by a preparatory meeting among the HHS team led by Andrea Palm. During that meeting Andrea got very upset with Henry Walke and Rochelle of CDC Because they were falling into the same trap as they did with COVID when they were indicating that they will likely go into slow walk the availability of diagnostics. It seems that the CDC just has not learned a lesson at all about the catastrophe regarding the availability of diagnostics during COVID. During the meeting with the deputies, my role was to tell them about the 100 doses of the Sudan ebola vaccine that we have at the VRC. it was a lot of discussion about everything from isolation to travel to availability of interventions to dealing with the Ugandans. There are currently no cases outside of Uganda in cases have been confined to four provinces in Uganda. There was a concern that the neighboring countries of Rwanda and DRC are vulnerable. Also, there was considerable discussion about how we would handle the entry of potentially or actually infected patients from Uganda into the country. Approximately 140 people a day fly in to the United states indirectly from Uganda since there are no direct flights from Uganda to the United States. JAMA news article by Len Strazewski: Dr. Fauci stood up for science when it counted. What’s next? Other variants are starting to evolve such as BA.4.6, BF.7 and BA.2.75.2:

Yesterday I went up to New York City to appear on The Late Show with Stephen Colbert. It was hilarious and the theme was to give people their booster shot. As part of the scripted show he asked me if I was going to get my booster and I said I'm due for it and he said well let's go get it. We got up walked out of the studio went to the Duane Reade pharmacy and got the shot. The response to the show has been phenomenal!! Many new variants hovering around. From Trevor Bedford: PRESS: NJ PBS “Chat Box” with David Cruz; News Nation with Chris Cuomo;

Note the growth advantage that BQ.1.1. has over BA.5. We definitely need to watch out for these new Omicron sublineage variants as we approach late Fall/early Winter : We are doing very poorly compared to other countries in boosting out population:

United States • Total Cases: 96,640,059 7-Day average: 38,949 (-11.9%) • Total Deaths: 1,058,692 7-Day average: 328 (-8.5%) • Total new hospital admissions: 5,400,083 7-Day average 3,268 (-4.4%) Worldwide [Source: WHO] - most recent day • Total Cases: 620,301,709 (417,329 new) • Total Deaths: 6,540,487 (1,094 new) I had a delightful zoom conversation with a 3rd year student at Bronx High School of Science – Ayshi Sen, an immigrant from Bangladesh. She is writing for her school newspaper and she asked for an interview. She was over the moon that I agreed to do the interview Considerable concern that is growing about the impact of new variants that have a transmission advantage and that evade the critical monoclonal antibodies such as Evusheld: PRESS: Interview with Erin Banco of Politico; Interview with The Guardian with David Smith

Crazy thing has now emerged. Boston University investigators have done an experiment that clearly would have fallen under the category of oversight by the P3CO process. Yet they never told our NIAID program people about it, nor was there any mention of these experiments in the grant that they cited in the pre print paper, nor was there any mention of this in the progress reports from the grant. What they did was swap an omicron spike on to a Wuhan matrix to determine the effect of the chimera on the function of the virus. As you might expect the people who have been attacking us for gain-of-function research are jumping all over this. We are putting out a statement indicating that we knew nothing of these experiments and they should have told us about them and put it through the P3CO process. Let us see how this plays out.

Had Tabletop exercise at the EEOB-350 for emergence of new variant. Led by Ashish Jha and Kevin O’Prey. Present was HHS crew (with Becerra virtual) and Denis McDonough (VA). Only 90 minutes. We really did not accomplish much. Some good comments by Denis McDonough. Am starting to feel the reality of the fact that I am leaving for good in about 7 weeks. A lot of clearing out to do in my office. PRESS: ABC (Local) WJLA TV – “Government Matters” with Mimi Geerges; Canadian Broadcasting Company (CBC) The National News Program (Exit interview) with Adrienne Arsenault; Al Jazeera TV; News Radio 849 WHAS (Kentucky News Station)

I received the call today from David Ho who had recently published a preprint article showing that the neutralizing antibody response against the BA4/5 variant induced by the bivalent BA 4/5 boost versus the ancestral strain boost were essentially equivalent, namely, the BA4/5 bivalent boost was no better than the standard boost. Last night, I heard from Pfizer in a zoom call with Jha and all of HHS (Walensky, Murthy, Kessler and my team at NIH) that in their experiments there was a fourfold higher titer associated with the boost by the bivalent BA4/5 compared to the boost with the ancestral strain. Pfizer claims that their study was controlled whereas the studies by Ho and Barouch were not and the numbers were small. David Ho called me today and emphasized that the combination of numbers of his study and Barouch's study made them equivalent in size to the Pfizer numbers. In addition, he made the important point that there were some discrepancies in the data that were in the press release from Pfizer which did not contain all of the data that made them concerned about the Pfizer data. In addition, David suggested that it is in Peter Mark's interest to agree with Pfizer since Pfizer confirms what his decision was about the BA4/5 bivalent boost. I do not know whether this is David Ho concerned that his data are not holding up or whether he has a very good point that Pfizer is not being totally above board with the presentation of their data. I will have to try to figure this out by discussing it with a few other people. I have already discussed it with Cliff Lane and he thinks that both of those studies don't definitively show the answer since they both have weaknesses. Cliff recommends that the data undergo significant statistical analysis. HOWEVER, Eric Topol reviews the different studies: Great put down of the HELP Report in LA Times: Column: ProPublica and Vanity Fair are pushing the COVID lab-leak theory, but their exposé is a train wreck BY MICHAEL HILTZIKBUSINESS COLUMNIST NOV. 1, 2022 1:15 PM P BQ.1 and BQ.1.1 continues to overcome BA4/5: PRESS: CBC TV “Rosemary Barton Live”;

Mark Dybul texted me to alert me that Mike Gerson was fading quickly and was in Georgetown Hospital waiting for Hospice. Bles Building, 4th Floor, Room 24. It was very sad to see. Mike was in dire straits literally on his last few hours to few days. He recognized me and was obviously very glad to see me. We had a brief conversation I told them how important he was to me and to the rest of the world and he said that he truly appreciated that. A truly great man will soon leave us. Was briefed today by the Moderna team led by Steve Hoge on the latest data of their bivalent BA4/5 boost. The data look really very good and it is clear that the updated booster performs very well and better than the ancestral booster across the board in inducing antibodies against BA 4/5 and all of the sub variants of omicron including BQ.1.1. This is very good news for the upcoming winter. However, there is still very little uptake of this updated booster by the general public. There is this complacency that the pandemic is over and the confusion about why we need to continually get updated boosts because of the combination of appearance of new variants together with the lack of durability of response to either vaccine or infection. Catch up on prior important information. From May, 2020: All of Jacob Wohl’s Spectacularly Failed Smear Attempts By Bridget Read Jacob Wohl. Photo: John Middlebrook/CSM/Shutterstock In my phone call with Ashish today, I emphasized that they need to dial this back since the naysayers (John Moore, Paul Offit, et al) will blast us for making statements without clinical data. I did the Oxford Union Fireside Chat via zoom– very enjoyable. PRESS: McClatchy TV “Exit Interview”; NEJM Podcast associated with my upcoming “exit commentary” in NEJM; My comment in Washington Post article by Dan Diamond today: “The supplemental requests that we keep putting in … just because they don’t go anywhere, doesn’t mean the need for them disappears,” Anthony S. Fauci, the government’s top infectious-disease expert, said in an interview last week.; Regional Media – “Make It Make Sense” with Monique Pressley; Rolling Out with Rashad Milligan; Philadelphia Tribune (print) with Alec Larson

Of note, all of the Omicron sublineages that we are currently dealing with are offshoots or sublineages of BA.2 (see below): Had a Sunday evening Zoom call regard the situation of boosts for children 5-6 years and younger (see above). It involved: me, Rochelle, Robbie Goldstein, Peter Marks, Rob Califf, Dawn O’Connell, Vivek Murthy, Larry Tabak, among others. We all agreed that this was a close call and both sides have a good point. The important issues is that this involved only about 5% of the eligible children since the other 95% have not yet received their primary vaccination and those are truly the vulnerable ones if we get a winter surge. At the end of January, 2023, the VRPAC will meet to recommend that going forward all vaccinations (primary series and boosters) will be the BA.4/5 bivalent and so this will be a moot point. The question still remains unsettled as to give the children the best boost now even though it logistically will be difficult for the pediatricians since they will have multiple (11) different products in their offices from Moderna + Pfizer) or wait until we have a uniform boost for everyone at the end of January. No firm decision was made. FDA will try to push the date for VRPAC closer to close the gap. More to come PRESS; Taped a segment with Margaret Brennan – CBS “Face the Nation” for next Sunday – somewhat of an exit interview